Print this page and complete this application. Bring the application to a regular club meeting - applicants MUST attend a meeting and have a member sponser them before they can be voted into membership. Regular meetings are held the 1st Monday and 3rd Thursday of the month (see website for location and directions).

 _____ Affiliate Member $10. Annual

 _____ Junior Member $5. Annual, $1. Initiation

 _____ Regular Member $10, Annual, $3. Initiation

 _____ Life Member 20 times annual dues (after 5 years membership)

 Name __________________________________________________________

 Street Address __________________________________________________

 City _____________________________ State ___________ ZIP _________

 Phone (Residence) __________________ Phone (Business) ___________

Email address ________________________________________________

 Age _____ Marital Status __________ Birth Date ____________________

 Years at Present Address _________

 Business Address ______________________________________________

Were you previously a member of the Red Rose Coin Club?_________________

 List any other Coin Clubs you have been affiliated with:

________________________________________________________________

Collecting Interests _________________________________________________

How did you learn about the Red Rose Coin Club? _________________________

Signature ________________________________________________________

 Proposed By ____________________________Member # ______________