Dakota City Heritage Village





This membership is: (   ) New  (   ) Renewing  

                                        Individual -  $10.00
                                        
                                        Family     -  $15.00




NAME ___________________________________________________________________________

ADDRESS ________________________________________________________________________

CITY ______________________________________________ STATE __________  ZIP__________

PHONE (        )_______________________________E-MAIL________________________________

Please make your check payable to: Dakota City Heritage Village, Inc.

Return your check with this form to:

    Membership
    Dakota City Heritage Village
    4008 220th St. W. Box 73
    Farmington, MN  55024


Contributions are tax deductible as allowed by law.