APPLICATION FOR MEMBERSHIP IN THE

NORTHWEST TOKEN & MEDAL SOCIETY, INC.

Please print & complete this form -- Mail to: Secretary, NWTAMS, INC., P.O. BOX 1365, OCEAN SHORES, WA 98569-1365

SELECT MEMBERSHIP OPTION

(Please make your check payable to NWTAMS, Inc.  Our Club year runs from Jan. 1st to Dec. 31st)

Enclose $10 if you are joining after  January 1st.  (U.S. funds only)
Enclose $15 if you are a family joining after January 1st.  (U.S. funds only)

 

NAME___________________________________________________PHONE_________________________

(If Family please list names)__________________________________________________________________

ADDRESS________________________________________________________________________________

CITY _____________________________________________________________

STATE/COUNTRY___________________________________________ZIP + 4_____________________

E-MAIL ADDRESS ________________________________________________

_____YES! PLEASE SEND MY NEWSLETTER VIA E-MAIL, THANKS.

E-BAY SELLER ID__________________________________________(Optional)

 

WHAT TYPE(S) OF TOKENS DO YOU COLLECT:

Washington Oregon Alaska Idaho B.C./Yukon Merchant By Town All Transportation

Other _______________________ _______________________

 

PUBLICATION ORDER FORM (Check the publication you wish, and enclose the price plus shipping if you reside outside of the US.) (Retail and Member’s price, includes shipping within the US.)

Washington State Trade Tokens by Al Erickson   606 pages  (1998)   $50 postpaid in USA

 I (we) agree, by my signature, to abide by the Constitution and Bylaws of the Northwest Token and Medal Society, Inc., and it's Code of Ethics.

Signed______________________________________________________________Date__________________

(Privacy statement:  Information provided on this application is never sold or distributed to any other organization, agency, service or business! Directory information may be provided to members only and restricted to name, collecting interests, email address and/or phone number. Check here if you do not wish to be listed in the member directory )