Admiral Digby Museum
Membership Application Form

Name:       __________________________________________________

Address:    __________________________________________________

                    __________________________________________________

Phone:       (____) ____________________________________________

Email:      __________________________________________________

Please check one of the following:

¨     Renewal of Membership                     ¨     New Membership

¨     Past Member (Membership has lapsed)

If you are a new member and were invited to join, include the name of the member who referred you to us: _________________________________________________________________

Membership Dues:             $  20.00

Donation Included:            $  ____________________

Total amount enclosed:    $  _____________________

Please indicate below how you prefer to receive your newsletter “The Atalanta”    

        ¨       Email (PDF File)           ¨       Mail

Print form, complete the requested information then return your application along with the $20.00 membership fee in person or by mail to:

Admiral Digby Museum
P.O. Box 1644,   95 Montague Row
Digby, Nova Scotia
B0V 1A0