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YES, I want to be part of the Central States Numismatic Society!
Name _____________________________________________________
Type of Membership: Adult __ Club __ Junior __ (Check One) ___Enclosed is $200.00 (US funds) for a life membership (Not Available to Foreign Residents) ___Enclosed is $10.00 (US funds) for a 1 year membership. (Adults and Clubs) ___Enclosed is $25.00 (US funds) for a 1 year membership. (Adults and Clubs outside of US) ___Enclosed is $3.00 (US funds) for 1 year junior membership RETURN APPLICATION WITH PAYMENT TO: Central States Numismatic Society P.O. Box 841 Logansport, IN 46947 E-mail Address (optional) _______________________________________________ I herewith make application for membership in the Central States Numismatic Society,
Signature of Applicant________________________________________Date_________ |
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