Pickwick Mill Membership Form

To utilize this membership form, please enter your information in the spaces provided,
select your desired membership, print the form, and mail with your check to:

Pickwick Mill Inc.
26421 Country Rd #7
Winona, MN  55987

You will be sent your membership card upon receipt of the completed form and check. Thank you for your support!

Member Information

Name:
Address:
City:
State:
Zip Code:
Phone Number:	( ) -
E-mail Address:

Memberships:

Lifetime Memberships:
	Membership	Cost	Member Receives
	Miller	$1000.00 and over	- Numbered Print of Mill - Plaque in Pickwick Mill - Plaque for Member
	Millwright	$500.00 - $1000.00	- Plaque in Pickwick Mill - Plaque for Member
Annual Memberships
	Cooper	$100.00	- Plaque in Pickwick Mill
	Family	$25.00
	Individual	$15.00
	Senior (65+)	$5.00

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