31 
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 amendments 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 
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eee ene eee ees ee 8.8 €eeeceoensr € @eaevedcedce@ eee € ee Geese @¢ee28 6 8 6. ¢ 
In the event that I shall apply at any time for a gratuity 
pursuant to the provisions of Section 14 of said Rules and 
The necessary forme will be supplied, upon application, by the Secretary of the Pension 
