Name: ___________________________________________________

Address: ___________________________________________________

City/State/Zip: ___________________________________________________

Phone: ___________________________________________________

E-mail: ___________________________________________________

_____  Check if you are interested in volunteering

Membership Dues: ($20 per household or business) $________________ enclosed

Special Gift: $ ___________________

Please make your check payable to "Friends of Rocheport Society"

Mail to: Friends of Rocheport Society                

P.O. Box 122                                                         

Rocheport, MO 65279                                           

How would you like to receive information from FOR?  

E-mail. ______

U.S. Postal Service ______

June - Hall of Fame Concert and Ceremony

June to October - Museum is open