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Membership Form


Bily Clocks Museum & Antonin Dvorak Exhibit
PO Box 258, Spillville, IA 52168


Check your annual membership desired and send your check or credit card information to the address above

Time & Music are Important at the Bily Clocks

 
____ $30 Seconds /Quarter notes   (one individual)

____ $50 Minutes / Half Note  ( two adults at same address children under 18)

____ $40 Half Hour / Full Note  (seniors, two adults at same address 65 or older)

____ $500 Hour / Quartet   (Life time member, two adults at same address,
children under 18)

____ $1000 Grandfather / Symphony 
(Business sponsor)

Annual membership entitles you to:

In addition, the Life and Business sponsor
entitles you to:

PAYMENT TYPE:
Check: $________
Credit Card NUMBER: _______________________
_____ Visa _____ Master Card _____ Discover
Expiration Date: _____________
Signature: ___________________________________

Name: _____________________________________
Address: _____________________________________
City: ___________________State: ____Zip: ________
Phone # _________________________

 

YOUR HELP IS NEEDED!
HELP KEEP THE BILY CLOCKS TICKING BY BECOMING A MEMBER TODAY!

Thank You