NATIONAL TOKEN COLLECTORS ASSOCIATION |
MEMBERSHIP APPLICATION |
| (Please Print Carefully) |
|
|
|
| Telephone (Home) |
|
(Work) |
|
(Fax) |
|
|
| E-Mail Address |
|
Personal Web Site |
|
|
| Token Collecting Interests (list up to 3) |
|
|
| |
I hereby apply for membership in the National Token Collectors Association. I agree that if I am elected to membership I will abide by the Constitution and Bylaws of the National Token Collectors Association, and its Code of Ethics.
Date ____________________Signature ____________________________________________
One-year membership benefits include 12 issues of TALKIN’ TOKENS mailed by first class postage, a free classified ad up to a maximum of 50 words in each issue, and a permanent membership card.
| Payment in US funds enclosed: |
One-year Membership - $36.00
|
$____________________ |
| |
Canadian Additional - $13.00 |
____________________ |
| |
Other Foreign Additional - $18.00 |
____________________ |
| |
|
____________________ |
| |
TOTAL REMITTANCE |
$____________________ |
| Please do not write in the space below |
REVISED 1/09 |
| Mail completed and signed application with check |
|
| or money order in US funds made payable to |
Referred by: __________________________ |
| NTCA or National Token Collectors Association to: |
|
| |
Membership No. Assigned _______________ |
| Clark Rohmer, Secretary |
|
| PO Box 281 |
Date Received: ________________________ |
| Ormond Beach, FL 32175 |
|
| (386) 677-4206 |
Added to data base: ___ TT: ___ Publications sent: _________
|
|