Membership Application

Print this page and complete this membership application. Bring the application to a regular club meeting to be sponsored for membership into the York Coin Club. Regular meetings are held on the 2nd Tuesday of the month (see website for location and directions).

______ Regular Membership $10 per year plus $5 initiation fee the first year

______ Junior Membership $3 per year

Name _______________________________________________________________________

Street Address ________________________________________________________________

City ______________________________ State __________________ ZIP _______________

Phone ____________________ E-Mail Address ____________________________________

Collecting Interests ___________________________________________________________

How did you learn about the York Coin Club? ____________________________________

Date of Application ___________________________________________________________

Signature ____________________________________________________________________

Proposed By _________________________________________________________________