Duo $75 Membership Form Includes all Standard Membership benefits Purchaser Information: for one individual and one guest Name:______________________________ Group $125 Standard Membership Benefits to the Buddy Includes all Standard Membership benefits Address:____________________________ Holly Center for two adults and up to two children (ages 7-17) Engraved Courtyard Brick ($125.00 City/State:__________________________ The following benefits are available to value)- placed permanently in the BHC Members at all levels for one year. Benefits Meadows Courtyard. Bricks are one time Zip code:____________________________ are subject to change. only; bricks are not given on membership renewals. Work Phone:_________________________ Free admission for one year to the Buddy Holly Center exhibitions Individual- Municipal Museums Joint Home/Cell Phone:____________________ 10% discount on select merchandise Membership $80 in the Museum gift shop Includes all Standard Membership benefits Email Address:_______________________ Discounts on Museum camps, for one individual at both the Buddy Holly classes and programs Center & Silent Wings Museum _ ___________________________________ Invitation to member-only events such as receptions, previews, and Group- Municipal Museums Joint Membership Level:____________________ Museum gift shop specials Membership $230 Subscription to the Museum's Includes all Standard Membership benefits Tee Shirt Size:________________________ member e-newsletter for two adults and up to two children (ages Personalized membership card Payment: 7-17) at both the Buddy Holly Center & Buddy Holly Center Member’s Only Make your check payable to The Buddy Holly Silent Wings Museum. Engraved Courtyard decal and one Buddy Holly Center Center or charge the fee to: Brick ($125.00 value)- placed permanently in Members Only T-Shirt the location of your choice- The BHC Card No.____________________________ Student $20 (w/Student ID) Meadows Courtyard or The SWM Patriot Includes all Standard Membership benefits Plaza. Bricks are one time only; bricks are Exp. Date___________________________ for one individual not given on membership renewals. Amount to Charge____________________ Additional bricks can be purchased for Individual $50 $125.00 Includes all Standard Membership benefits Authorized Signature for one individual ___________________________________ TM Maria Elena Holly BHC Meadows Courtyard Engraved Brick or Tile Brick (4”x8”) $125 Tile (8”x8”) $500 Name: Please print name(s) as you would like it to appear. You are allowed 2 lines with up to 14 characters per line. Or check here if you would like to dedicate your brick in memory or honor of someone: In memory of: In honor of: Your name: Address: Phone: Fax: Email: Payment Method: (please circle one of the following) Check or Charge to card type: _______________ Amount: _______$125 _______$500 Account Number Expiration Date Signature .