Issue link: https://www.e-digitaleditions.com/i/493339
Complete the appropriate sections of this page to enroll as a Society member, renew your membership, give a gift membership, or order items from e Dome Marketplace. If you are giving a gift membership, please provide the person's name and address below. GIFT MEMBERSHIP: _____________________ _____________________ _____________________ CAPITOL ALUMNI MEMBERS Tell us your connection with the Capitol. _____________________ _____________________ EVENT REGISTRATION: List the events that you wish to attend. Include your name (s) and contact information. YES, I/WE WILL ATTEND: _____________________ _____________________ You may fax this form to: (202) 544-8244 or mail it to: USCHS, 200 Maryland Ave., NE Washington, DC 20002-5796 QUESTIONS? Toll-free (800) 887-9318 x10 Local calls: (202) 543-8919 x10 Item Number Quantity Unit Price Extended Price Complete form and fax to (202) 544-8244, or call toll free: 1-800-887-9318, ext. 10 SHIPPING AND HANDLING $20.00 (OR LESS) $7.95 $50.01 to $75.00 $18.95 $20.01 to $30.00 $8.95 $75.01 to $100.00 $24.95 $30.01 to $40.00 $12.95 More than $100.00 $34.95 $40.01 to $50.00 $14.95 Please add $25.oo shipping for each framed print ordered. For packages over 25 lb., add $10.00 per additional 10 lbs. SUB-TOTAL: ______________________ TAX (6% DC & MD): ________________ SHIPPING: _______________________ MEMBERSHIP: ____________________ TOTAL: __________________________ Enclosed is a Check or Money Order payable to: U. S. Capitol Historical Society I am paying by Credit Card (please circle one): VISA MC AMEX DISCOVER CARD # ______________________________ EXP. DATE: _______________ CODE: _____________Cardholder Signature (required): ____________________ USCHS Board of Trustees Gary Abrecht Hon. Richard Baker, Ph.D. Ken Bowling, Ph.D. Hon. Richard Burr Donald G. Carlson Hon. E. omas Coleman L. Neale Cosby Scott Cosby Nancy Dorn George C. "Bud" Garikes David Geanacopoulos Leslie Hayes Bruce Heiman Hon. Richard Holwill Mark Hopkins R. Bruce Josten Tim Keating Hon. Dirk Kempthorne Jennifer LaTourette Rob Lively Tamera Luzzatto Tim Lynch Norm Ornstein, Ph.D. Beverly L. Perry Hon. David E. Price David Regan Cokie Roberts Hon. Ron Sarasin Mark Shields Dontai Smalls Tina Tate Hon. Ellen O'Kane Tauscher James A. urber, Ph.D. Hon. Pat Tiberi Hon. John C. Tuck Hon. Tom Udall Deborah A. White Candida P. Wolff J. Dennis Molloy (counsel) e Capitol Dome is a quarterly publication of the U.S. Capitol Historical Society, 200 Maryland Ave., NE, Washington, DC 20002 P: (202) 543-8919 F: (202) 544-8244 Toll Free: 1-800-887-9318 Email: uschs@uschs.org Web: www.uschs.org Chief Historian: Donald R. Kennon Editor: Lauren Borchard Designer: Diana E. Wailes All uncredited photos are courtesy of the U. S. Capitol Historical Society. For more information on membership categories and benefits, visit: www.uschs.org. For additional product choices, visit: www.uschscatalog.org or www.constitutionstore.org. READER RESPONSES Y O U R I N F O R M A T I O N Name(s)______________________________ Email: _________________________ Street Address: ________________________________________________________ City: _________________________ State: ___________ Zip Code: _____________ CHECK ALL THAT APPY: New Membership Membership Renewal Gift Membership Event Registration Marketplace Order Volunteering L E V E L O F M E M B E R S H I P $50-$74 $75-$99 $100-$249 Charter Membership Freedom Society Cornerstone Society $250-$499 $500-$999 $1,000-$4,999 Rotunda Society Architect of History Capitol Circle Please record me as a Capitol Alumni Member D O M E M A R K E T P L A C E M E T H O D O F P A Y M E N T