Membership for Application
print out and mail to address at bottom
Name: _______________________________________________
County:
______________________________________________
Address:
_____________________________________________
City: _______________________ State: ____
Zip Code: _____
Recommended
by:
_____________________________________
Numismatic
Specialties:
_________________________________
____________________________________________________
Other
Club Affiliations:
_________________________________
Dues
Schedule:
Adult $10.00
Junior (to age 18) $5.00
Club: $30.00
Foreign (Outside U.S.A.) $25.00
Life $350 (Over 55: $300)
(Life membership applications must be approved by the Board of Directors.) SEND TO: Michigan State Numismatic SocietyPost Office Box 87931Canton, Michigan 48187