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:
Contributions are tax deductible as allowed by law.
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.
