Membership Registration

Membership Type

Individual ($15.00)

Family ($36.00)

Sustaining ($80.00)

Benefactor ($120.00)

Gold Guardian (Benefactor + additional donation)

Additional Donation (Tax-Deductible)

Payment Option

Check payable to Historic Indian Agency House (mail to 1490 Agency House Rd., Portage, WI 53901)

Credit Card (After hitting the "SUBMIT" button, click "DONATE" to pay for your membership.)

Membership Card Delivery

I will pick up my membership card(s) in person during open hours (This option saves postage costs.)

Please mail my membership card(s) (We are happy to do this, as well!)

Please send a receipt for tax purposes (if applicable)

Yes

No

Historic Indian Agency House