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SBCCA Membership Application
If you are interested in joining the
SBCCA please print the following application form, and mail it along with one of
the following amounts to:
SBCCA Membership
Chairman
440 Homestead Ave.,
Metairie, LA 70005
Membership desired: (check one)
( ) Individual $35 ( ) Individual / Spouse - other + full privileges $45
( ) Other $35 ( ) Overseas Membership $45
Name
___________________________________________
Address _________________________________________
City _______________________
State/Province
Zip Code
Country
Do you object to having your full address published
for members use only?
*If you do only your
Name, City and State will be used
If you wish your
telephone numbers and other contact detail please complete the below
Home:(
) - -
Office : (
) - -
Fax: (
) - -
Email:
Web:
Are primarily a Collector ( )
Dealer ( )
or Both ( )
How long have you been collecting banks?
Number of still banks in your collection at this time?
I am interested in still banks. Enclosed is my personal
check or money
order for annual dues made payable to:
STILL BANK COLLECTORS CLUB OF AMERICA.
I understand that membership is on an annual basis from
January 1 thru December 31 of each year and that I am entitled to all
publications or rights afforded members in good standing on January 1 of the
current year.
Those joining prior to the June convention will
receive full membership and all material retroactive from the first of the year.
The following years dues will be due Jan 1. Those joining after the annual
convention will receive complementary mailings along with full membership for
the balance of the year and paid in full for the next year (potentially 18
months). There after it will be on an annual basis.
Your Signature:
Spouse / Other {If applicable):
Date:
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