Membership Form
(Fields marked in bold are required.)

Payment Method

Membership Level

Member Details

Please provide member name(s) as it should appear on the card.

Gift Membership (if applicable)

This is a gift membership for (provide name as it should appear on the card):

Send Gift Card To:

Send Renewal Notice To:

Membership Total

Children's Scholarship Contribution (tax deductible)


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Mailing Instructions

Please mail your printed membership form along with a check for the total amount due to:
Lewis & Clark Foundation
P.O. Box 398
Great Falls, MT 59403