A Chapter of the ABA, BCCA and NABA

 

TWO YEAR MEMBERSHIP APPLICATION

2024 & 2025

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DATE: ________ NEW______ RENEWAL______  CHECK MARK OTHER CURRENT MEMBERSHIP BELOW       

     

NAME: _____________________________________________ABA______BCCA______NABA________

 

ADDRESS:  _____________________________________________________________________________

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CITY/STATE/ZIP:  _______________________________________________________________________

 

PHONE (            ) ________________________  (CIRCLE ONE):   CELL    OR     HOME

 

EMAIL:  _______________________________________        (PLEASE PRINT VERY CLEARLY!)

 

WEBSITE URL: (if applicable) __________________________

 

COLLECTION SPECIALTY: _______________________________________________________

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OCCUPATION:  _________________________________________________________________  

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COMMENTS/SUGGESTIONS:  ___________________________________________________________________________

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If you have an email, PLEASE PRINT YOUR EMAIL CLEARLY AS YOU WILL BE RECEIVING YOUR NEWSLETTER VIA EMAIL.

                                      

                     Membership fee:  $15.00 email, $25.00 to have it mailed to you

                                      

                                                    Make Checks payable to: Olde Frothingslosh

and sent to:

                                                                     Olde Frothingslosh

                                                                     C/O Keith Wilson

                                                                     2002 South Trillium Drive

                                                                     Aliquippa, PA  15001