Membership Registration Form

Online memberships will be processed within 1-2 weeks from online submission date and
gift memberships will be sent priority mail. If you will be visiting the Museum within that time,
please sign up for membership at our box office upon arrival.

This is a:
	New Membership
	Membership Renewal
	Gift Membership *Fill in contact information for person receiving gift membership below
Membership Plan
	Individual ($40) - Benefits for one individual
	Family ($95) - Above member benefits for up to two adults, up to four children or grandchildren under the age of 18, priority booking of birthday parties at the Museum, and discounted rate on Museum's Summer Camp.
	Contributor ($250) - All of the above plus $75 off Summer Camp class, invitation to VIP/Museum receptions, 10% off birthday parties and facility rentals, tote bag, t-shirt, and 2 guest passes.
	Donor ($500) - All of the above plus an additional $25 off Summer Camp class, a gift Family membership for a friend or family member, and behind the scenes tour of exhibits.
	Benefactor ($1,000) - All of the above plus recognition on the Museum's Donor Board, an additional $50 off Summer Camp class, an additional 10% off birthday parties and facility rentals, an additional gift Family membership for a friend or family member, $50 donation to the Summer Camp Scholarship Fund, and lunch with the Museum President.
Additional Packages
	Young Professional Package ($100)
	Reclamation Project Membership Package ($45)
	Smithsonian Affiliate Membership Package ($15) Smithsonian Magazine (12 issues) OR Air & Space Magazine (6 issues)
General Information
Adult 1:
Adult 2:
Adult 3:	*One additional adult can be added onto any of the Membership levels, except for the Individual Membership level, for an additional $30.
Children's Names & Birthdates:	** Up to four additional children can be added onto any of the Membership levels, except for the Individual Membership level, for an additional $10 each.
Address Line1:
Address Line2:
City:
State:
Zip Code:
Phone #:
E-Mail:
Payment Information
Credit Card Type:	Click Here Visa MasterCard American Express
Name on Credit Card:
Credit Card #:
Expiration Date:
Gift Membership Message
Message sent with gift membership:
Automatic Renewal The Miami Science Museum is pleased to announce an automatic membership renewal option. You can now be worry free when it comes to renewing your membership and continue to enjoy uninterrupted benefits year- round.
I authorize the Miami Science Museum to automatically bill the credit card at the current price for my membership renewal on the anniversary of payment.
Yes No