1892 Society Campaign

Name: _________________________________________

Address: _________________________________________________

City: ________________________ State: ______ Zip: ____________

or

Country: ______________ City: ___________________ Postal code: __________

 

Write in your donation amount next to the appropriate category:

$25,000+ _________ $20,000+ _________ $15,000+ _________

$10,000+ _________ $5,000+ _________ $1,000+ _________

Other _________

Donations of $1,000 or more qualify you to be a member of the 1892 Society and a life member of
the AUSS Cultural Heritage Foundation. An additional $200 qualifies as a family life membership.

Name, as you’d like it to appear: _______________________________

Make check payable to AUSS Cultural Heritage Foundation

Send this completed form to James R. Maurice at one of the addresses below:

May-December:
445 E. North Water St. E2203
Chicago, IL 60611-5542

January-April:
670 Island Way #904
Clearwater, FL 33767

For more information contact Jim at:

May-Dec.: (312) 670-9570

Jan.-Apr.: (727) 729-6269

E-mail (all yr.): JMaur61541 @ aol.com

1892 Society page

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