MEMBERSHIP APPLICATION

LAST NAME

FIRST

MIDDLE

Mourning Stamps and Covers Club

STREET ADDRESS

P.O.BOX

APT#

ZIP/POSTAL CODE

COUNTRY

CITY

STATE/PROVINCE

TELEPHONE NUMBER

E-MAIL

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 in the information and mail it along with your payment to the address shown.  Thank you.

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MAIL APPLICATION

AND PAYMENT TO:

James N. Camak

3801 Acapulco Court

Irving, TX  75062

USA

RETURN TO MEMBERSHIP PAGE

(BACK)

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)

MAIL

(BLACK & WHITE)