APPLICATION FORMS 



APPLICATION FOR MEMBERSHIP* 



To the Pension Board of the 



American Museum of Natural History : 



I do hereby subscribe to the Pension Fund of the American 

 Museum of Natural History and to the Rules and Regulations of 

 said Fund, a copy of which has been received by me. I agree to 

 be bound by the said Rules and Regulations and by any amend- 

 ments thereof adopted as therein prescribed. 



I hereby designate as my beneficiary or beneficiaries, for the 

 purposes specified in said Rules and Regulations, the following 



person who now reside at the following address , 



namely : 



Name Address Relationship 



In the event that I shall apply at any time fc»r a gratuity pursu- 

 ant to th« ns of Section 14 of said Rules and Regulations, 



• The necessary forms will be supplied, upon application, by the Secreturv of the 

 Pension Board. 



