Indicate Membership Level: Student $10.00 Family $50.00 Model Railroad Club $20.00 Lifetime $250.00 Individual $30.00 Corporate $500.00
	Enclosed please find payment of $
	Name:
	Spouse's Name:
	Street Address:
	City: State: Zip:
	Please make check payable to: Historic Lake Wales Society
	Interested in volunteer opportunities
	Print and complete form, then mail with payment to:
	Historic Lake Wales Society c/o The Depot 325 S. Scenic Highway Lake Wales, FL 33853