MEMBERSHIP APPLICATION
LAST NAME
FIRST
MIDDLE
STREET ADDRESS
P.O.BOX
APT#
ZIP/POSTAL CODE
COUNTRY
CITY
STATE/PROVINCE
TELEPHONE NUMBER
I HEREBY APPLY TO JOIN THE MOURNING STAMPS AND COVERS CLUB, AND AGREE TO THE TERMS AND CONDITIONS OF MEMBERSHIP. I ENCLOSE CHECK/CASH COVERING DUES FOR THE CURRENT YEAR. *(MEMBERSHIP DUES OF $15.00 FOR THE ENTIRE YEAR ARE PAYABLE, NO MATTER WHEN THE APPLICANT JOINS THE CLUB. ALL BACK ISSUES OF OUR NEWSLETTER/JOURNAL FOR THAT YEAR WILL BE SENT TO THE NEW MEMBER).
Print out this page. Fill out and mail form with payment to the address shown below, or pay by PayPal and email this form to: Thank you.
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MAIL APPLICATION AND PAYMENT TO:
JAMES CAMAK
3801 Acapulco Court
Irving, TX 75062
USA
TERM
YEARS
AMOUNT PAID
SIGNED
DATE
HOW DID YOU HEAR ABOUT THE MSCC?
WHAT ARE YOUR COLLECTING INTERESTS OR AREAS OF SPECIALIZATION?
HOW LONG HAVE YOU BEEN COLLECTING MOURNING COVERS?
QUESTIONS OR COMMENTS?
METHOD OF RECEIVING NEWSLETTER/JOURNAL
E-MAIL/PDF
(COLOR VERSION)
(BLACK & WHITE)
