Membership for Application
Name: ______________________________________________________________
Address: ____________________________________________________________
City: _______________________________ State: _________ Zip Code: __________
___________________________________________________________________
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 Society
Post Office Box 87931
Canton, Michigan 48187