Membership Form

First Name*

Last Name*

Address 1*

Address 2

City*

State/Province*

Country*

Postal Code*

Phone*

Email*

Preferred Form of Contact*

Type of Membership*

Payment

Credit Card Number*

Expiry Date*

CVC/CVV*

Contact Information*

I agree to my name and contact information details being used by LHMS for contact and organisation purposes. This information will not be made available to any other party.

Involvement*

I would like to find out more about volunteering my time to help the museum and other support opportunities

Donations*

I would like to be contacted about donating to the new Museum building

Te Ūaka Lyttelton Museum is currently closed while we fundraise for our rebuild.