Membership Application

Meets every 1st & 3rd Fridays of each month at:
 
  The Reformed Church of Syracuse
  1228 Teall Avenue
  Syracuse, NY
 
Meetings begin at 8:00 PM

Date: ___________________

The undersigned desires to become a member of the Syracuse Stamp Club and will abide by the Constitution and By-Laws of this club if elected to the membership.

Signature: _________________________________________

Name: ____________________________ Tel. No.: ___________________

Address: ______________________________________________________

City: _____________________________  State: _____________________

ZIP: __________   E-mail Addr:____________________________________

Philatelic Affiliations: ____________________________________________

Occupation: ___________________________________________________

Collecting Interests:_____________________________________________

How did you learn about the Syracuse Stamp Club?

_________________________________________________________

 Recommended By:_________________________________

Dues must accompany this application
Dues:  Regular Member $ 12.00/year  Junior Member  $1.00/year
          Family Plan $12.00/first adult, $6.00/second adult
Dues Received by Treasurer: _______________________
1st Reading for membership: _____________ Date elected: _____________
                                       Secretary                            Secretary
 

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Michael Ammann, President

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