|
Membership Form
|
Mail
your Payment...
|
|
Please
PRINT THIS FORM
Send w/US bank cashier, Personal
check, or US Postal money order to:
Thimble Collectors
International
TCI Membership Chairperson
3997 Gumwood Court
Chantilly, VA
20151-2601
|
Membership Type
|
Annual
Membership
|
Number
of Memberships
|
|
Total
|
|
US
|
$35.00
|
|
=
|
$
|
|
International
|
$40.00
|
|
=
|
|
| |
Total of Membership
Fees:
|
$
|
|
Name
_________________________________________________________
|
|
Address
_______________________________________________________
|
|
City
& State
____________________________________________________
|
|
Zip
Code ____________ Email Address
___________________________
|
|
Country
__________________ Telephone __________________________
|
|
Signature
___________________________________ Date _____________
|
Do we have your permission to print the above
information in the Membership Directory?
(We do not share
your information with
anyone)
Please circle
one:
Yes
No
|