YES, I want to be part of the Central States Numismatic Society!
Type of Membership: Adult __ Club __ Junior __ (Check One)
___Enclosed is $250.00 (US funds) for a individual life Membership (Not Available to Foreign Residents)
___Enclosed is $350.00 (US funds) for a club life Membership
___Enclosed is $15.00 (US funds) for a 1 year Regular Membership. (Adults)
___Enclosed is $25.00 (US funds) for a 1 year Regular Foreign Membership. (Adults and Clubs outside of US)
___Enclosed is $25.00 (US funds) for a 1 year US Club Membership.
___Enclosed is 10.00 (US funds) for 1 year Associate Membership (Associate membership does not receive "The Centinel" and must be a household member of a Regular member.)
___Enclosed is $5.00 (US funds) for 1 year Junior Membership
RETURN APPLICATION WITH PAYMENT TO:
Central States Numismatic Society
c/o Secretary Patricia Foley
PO Box 210710
Milwaukee, WI 53221
E-mail Address (optional) _______________________________________________
I herewith make application for membership in the Central States Numismatic Society,
Signature of Applicant________________________________________Date_________
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