31 

 APPLICATION FORMS 



APPLICATION FOR MEMBERSHIP* 



T>> th, I \ <mn 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 



id Fund, a copy of which has been received by me. I 



to be bound by the said Rules and Regulations and 



by any amendments thereof adopted as therein prescribed. 



I hereby dee as my beneficiary or beneficiaries, for the 



pun itied in said Rules and Regulations, the following 



ion... .who now reside. . . .at the following address. . . ., 

 namely : 



Name Address Relationship 



In 1 r shall apply al any time for i gratuity 



want to of said Rules and 



The necessary forms will be supplied, upon application, by the Secretary of the Pension 



F I ■ i 



