Membership renewal notice

MBSID Number: 

Please access the MBSI website ( – to edit your personal records.  You can also renew in the members only section.

Name: __________________________________________________________________

Street: ___________________________________________________________________

City: ___________________________________________________________________

State: ___________________________________________________________________

ZIP: ___________________________________________________________________

Country: ___________________________________________________________________

Email:  __________________________________________________________________

A prompt reply will maintain your membership and continue your MBSI publications without interruption.

SPECIAL OFFER: Purchase one or more gift memberships at $15 off the New Member’s first year’s dues (New member must not have been a member during the last three years). For each gift membership you purchase, you will receive a $5 discount on your next year’s dues.

Gift Membership Name(s)________________________________________________________________________

Address, City, State, Zip Code______________________________________________________________________

Phone:____________________ Fax:___________________E-mail:________________________________________

Please list additional gift memberships on a separate sheet.


(A membership includes up to two adults and immediate family living in one household)

$60 United States
Unrestricted General Fund$________
$70 Canada or Mexico$________
Endowment Fund (promotes the purposes of MBSI)
$75 Other International$________
Ralph Heintz Publications Fund (special projects)
Optional Service (Additional)

Video Project (production of the MBSI DVD)
        $20 Airmail (OUTSIDE US ONLY)$________
Museum Fund (supports museum operations)

#___ Gift Membership(s) X $45each


                    TOTAL DONATION$________

           GRAND TOTAL (Total Membership Fees + Total Donations)   $_____________

______Check Enclosed      We accept MasterCard, VISA or Am Exp___________________________________________________

Expiration Date(mm/yy)____________ Security code (follows the card # in the signature area on the back of card ___________

Signature______________________________________ Phone # REQUIRED_________________________________________

We also accept Paypal through the MBSI website or through paypal at using email address