YES, I want to be part of the Central States Numismatic Society!
Type of Membership: Adult __ Club __ Junior __ (Check One)
___Enclosed is $15.00 (US funds) for a 1 year membership. (Adults in United States)
___Enclosed is $10.00 (US funds) for a 1 year Associate membership.
___Enclosed is $5.00 (US funds) for 1 year junior membership
___Enclosed is $250.00 (US funds) for a life membership (Not Available to Foreign Residents)
___Enclosed is $25.00 (US funds) for a 1 year membership. (Clubs)
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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