Wisconsin Heritage Online – Membership Dues *
FY13 (July 2012-June 2013)
Large organization $100
Small organization $ 50
Each institution determines whether they are large or small. For-profit organizations are invited to join at the $100 level.
Name of Institution: __________________________________________
Street Address: __________________________________________
City/State/Zip: __________________________________________
Contact Person: __________________________________________
Email address: __________________________________________
Phone: __________________________________________
We will join/renew Wisconsin Heritage Online in the ___LARGE___SMALL category.
_______ Please send invoice.
_______ A check is enclosed. Make check payable to Wisconsin Library Services.
_______ Remove from deposit account.
RETURN to:
Wisconsin Heritage Online, 728 State Street Room 464, Madison, WI 53706
FAX: 608.262.6067
or email to Emily Pfotenhauer, epfotenhauer@wils.wisc.edu
* The figures above are suggested contributions. Please give what your budget can handle. Thank you!