Madison Trust for Historic Preservation · Membership Form

Member Information

Madison Trust for Historic Preservation is a registered 501(c)(3) nonprofit organization. Our Federal Tax ID Number is 23-7356105. Your contribution is tax-deductible to the extent allowed by law.

Please provide your contact information to make sure our records are up to date.

Name

*

First Name

Last Name

Spouse/Partner Name (not required)

First Name

Last Name

Organization/Employer

Many companies offer a matching-gift program to their employees or, in some cases, family members of employees and/or retirees. Taking advantage of your employer’s matching-gift program allows you to double your donation (or more). Please check with your human resources department to see if your employer has a matching-gift program. Your completed matching-gift claim form can be either mailed or emailed to us at info@madisonpreservation.org.

Email

If you would like to receive correspondence electronically from us regarding your membership, you must provide your email address.

Verify Email

Home Phone

*

Your home phone can be a landline or a mobile phone. We provide a separate mobile phone option if you have and want to provide both.

Mobile Phone

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

What is your preferred communication for acknowledging your donation?

*

Prefers email

Prefers mail

Prefers both

Prefers none

What is your preferred communication for sending renewal notices?

*

Prefers email

Prefers mail

Prefers both

Prefers none

Would you like to receive our monthly e-newsletter?

*

Our e-newsletter is sent out the first day of the month and includes information on tours, events and advocacy.

Yes

No

I already receive it!

Would you like to receive our Advocacy Alerts via email?

Yes

No

I already receive it!

How did you hear about the Madison Trust?

Madison Trust Member

Friend or family member

Social media

Tours or events

Madison Trust newsletter

Madison Trust website

Other

Membership Level Information

Our Commitment to Our Donor Privacy

We will not sell, share or trade our donors’ names or personal information with any other entity, nor send mailings to our donors on behalf of other organizations.

This policy applies to all information received by Madison Trust for Historic Preservation, both online and offline, as well as any electronic, written or oral communications.

To the extent any donations are processed through a third-party service provider, our donors’ information will only be used for purposes necessary to process the donation.

Please select your membership level

*

$1,000 - Federal

$500 - Greek Revival

$250 - Italianate

$100 - Queen Anne

$60 - International

$50 - Craftsman (Family)

$40 - Prairie (Individual)

$25 - Tudor Revival (Student)

Donation Schedule (Please select One Time; to make a single gift, or Annually; to renew your membership automatically on this date each year.)

Membership Form | 2024