YES!  I want to keep Mary Emery's Dream Alive!

Name: _______________________________________________                  Tel.No. _______________________

Address: ____________________________________________________________________________________________

Email address: (MPF use only - for updates and news) _______________________________________________________

Membership Levels

* $20 Carillon             * $35 Family Statuary               *   $50 Pavilion               *    $100 Concourse 

(Concourse Level Contributors will receive a choice of either a limited edition print of Mariemont Cupolas by John Ruthven or

The Mariemont Story by Warren W. Parks)                           

I wish to receive * The Mariemont Story or * Cupola Print

* $1,000 and up - Mary Emery Club Lifetime Member 

     (can be given in payments of $500 over two years: Lifetime Membership status is attained after second donation)

Lifetime members will receive a gift of either John Ruthven's limited edition print "Mariemont Cardinals" or a set of thee decorative "Mariemont Plates"

I wish to receive * The Mariemont Cardinals Print * Set of three decorative plates

*      Please send me information about remembering MPF in my Will.

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Please print and return this form with your donation to:

                                    Mariemont Preservation Foundation, 3919 Plainville Road, Cincinnati, Ohio 45227