Make checks payable and mail to: Scouting Museum Daniel Webster Council BSA 571 Holt Avenue Manchester, NH 03109-5214 Phone 603.669.8919 Fax 603.625.2467

Please Print: Name:        __________________________________________ Address:    __________________________________________ City/State: ______________________, ___________________ Zip:           ____________-__________ Phone:      (_____) ______-__________

SCOUT MEMORABILIA SUBSCRIPTIONS   1 Year 2 Years 3 Years USA $9.00 $18.00 $24.00 Foreign & Canadian $15.00 ------- $35.00 BACK ISSUE SPECIAL From: Vol. 22 No. 4, September 1987 To: Vol. 41 No. 3, September 2006 Order any one Issue, (Regular priced $2.25) Order any five issues @ $2.00 each Order any ten issues @ $1.50 each Order any twenty issues @ $1.00 each

Gift Shop Order Form Quantity Item Item Price Total                                           Sub-Total: $   Shipping: $   Gift Shop Total: $   Friends Total: $   Scouting Memorabilia Total: $   GRAND TOTAL: $  Shipping & Handling Charges $.00 - $10.00 add...................................$3.00 10.01 - $25.00..........................................4.00 25.01 - 50.00............................................5.00 50.01 - 75.00............................................6.00 75.01 - 100.00..........................................7.00 Over $100.00..........................................10.00 ( ) Check or Money Order Enclosed ( ) VISA ( ) MasterCard Card Number______________________________________________ Expiration Date_____________________________________________ Signature:_________________________________________________   Friends of the Museum Level of Participation           (   ) Friends                            $      25.00        (   ) Associate                         $     50.00        (   ) Advocate                         $    100.00        (   ) Patron                              $    250.00        (   ) Benefactor                       $    500.00        (   ) Life                                  $ 1,000.00