Membership Form – for Payment by Cheque or Money Order

First & Last Name (required)

Renewing (required)
YesNo

Information Changed (required)
YesNo

Your Email

Include Email in Roster Listing (required)
YesNo

Telephone (10 digits)

Include Telephone in Roster Listing (required)
YesNo

Address (Please complete for CHANGED INFORMATION or for NEW MEMBERSHIP)

COLLECTING INTERESTS for Roster if NEW or CHANGED from previous

Annual Membership Fees:(required)
CAD $22.00 to CanadaCAD $32.00 to USACAD $35.00 Outside North America

After completing and submitting this Membership Application please make your payment:

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