Missouri Center for the Book Membership

P.O. Box 2075
Jefferson City, MO 65102-2075
Name  
Address  
City  
State/Zip+4  
Phone  
E-mail  
Membership type (circle one)
$35-Individual | $100-Family | $175-Friend

$300-Institutional | $500-Lifetime Individual | $1000-Corporate | $5000-Benefactor

Make checks payable to The Missouri Center for the Book.
Mail this completed form with payment for the amount circled above to:
Missouri Center for the Book, P.O. Box 2075, Jefferson City, MO 65102-2075.