PENNSYLVANIA ASSOCIATION OF NUMISMATISTS

MEMBERSHIP APPLICATION FORM


YES, I want to be part of Pennsylvania's State Coin Club. I understand that I will receive the Association's journal The Clarion (three issues per year) ; I will receive notification of upcoming PAN coin shows and conventions; my membership dues will help support PAN's numismatic education efforts across the state.

Name _______________________________________________________

Street _______________________________________________________

City _________________________________________________________

State _____________________________ Zip Code ___________________

Phone ___________________________

Other numismatic organizations I have been affiliated with:

_______________________________________________________________________
 

My collecting interests are:

_______________________________________________________________________
 

Enclosed is a check or money order for $10.00 (US) payable to PAN, for a 1 year individual membership.

Associate Memberships (same address) are $5.00 and Lifetime memberships are $200.00 
RETURN APPLICATION WITH PAYMENT TO:


Pennsylvania Association of Numismatists
Charles Culleiton
2080 Hastings Avenue
Lower Burrell,PA 15068

E-mail address: skipcull@verizon.net



I hereby make application for membership in the Pennsylvania Association of Numismatists, subject to the bylaws of the association.

Type:  __individual ($10)   __associate($5)     __lifetime($200)    
 

_______________________________________________________________________
Signature of Applicant/ Date


updated: 4/15/2012
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