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Moving Forward, Celebrating and Presrving the Past

Thank You for renewing your BRHS Membership!

Please print this page and then enter the information asked for on the form below.

Your Name: ___________________________________________    BRHS Member Number: __________________
Address: ________________________________________________________________________________
City _____________________________ State ______________ ZIP/Postal Code _________________
Mobile Phone Number _____________________     House Phone Number _____________________  
Email Address: _____________________________________________
Membership Renewal Term -- circle one:      [One Year]        [Two Years]     [Three Years]
Membership Level -- circle one:   [Regular $40]    [Sustaining $80]     [Conductor's Club $100]
If you do not reside in the USA or it's territories, please add $20 for postage. __________________
Total payment amount enclosed: _______________
Has your contact information changed?  -- circle one:     [YES]         [ NO]

Mail a copy of this completed form along with your check to:

Burlington Route Historical Society
Membership Renewal Services, Dept. I
P. O. Box 456
La Grange, IL 60525

Note: Allow 7-10 days for your renewal to be processed. For instant renewal use the on-line renewal feature.
Form RN-2022-09-01