Membership Application

Renewal Membership Application

Family/Dual Individual Non-Resident - outside L&M postal code region  $149/ yr  $269/ 2 yr  $97/ yr  $172/ 2 yr  $102/ yr  $183/ 2 yr 2 Members named on cards + 4 kids, Member named on card Members named on cards + 4 kids, 17 yrs and under 17 yrs and under

Student Senior Family ROM Social  $54/ yr  $145/ yr  $149/ yr Member named on card Primary cardholder (65+ years) + Member named on card + one guest 1 adult & 4 kids, 17 yrs and under

Curators’ Circle* Museum Circle* Director’s Circle*  $189/ yr  $323/ yr  $626/ yr

* Free entry for Curators’ Circle, Museum Circle and Director’s Circle Members includes: 1 Member named on card & 3 guests plus 4 kids, 17 years and under OR 2 Members named on cards & 2 guests plus 4 kids, 17 years and under.

TO RENEW: Complete and scan form and e-mail to [email protected], drop by the Membership desk, call 416.586.5700, or mail to address below.

First Cardholder Name: ______Member ID #: ______ Mr.  Ms.  Mrs.  Miss  Dr.

Second Cardholder Name: ______ Mr.  Ms.  Mrs.  Miss  Dr.

Address: ______Apt#. ______

City: Prov: Postal Code: ______

Home/Cell Phone: ______Business Phone: ______

E-mail: ______

PAYMENT METHOD  Cheque  Credit Card:  Visa  MasterCard  AMEX Payable to Royal Ontario Museum

Credit Card #: ______Expiry Date: ______

Name on Card: ______Signature: ______

Your privacy is important to us. The Royal Ontario Museum (ROM) and the ROM Governors (the ROM’s charitable foundation) share a special relationship and you may receive additional information from each. If you do not wish to receive it, please check here.  Occasionally, we make our lists of supporters available to other carefully screened organizations and selected groups that may be of interest to you. Please understand that by allowing us to exchange your name, you are helping to build a stronger constituency to support the education and research of the Museum. If you prefer not to have your name exchanged, please check here.  Should you prefer not to be contacted by our telemarketing department, please check here. 