SCSC APPLICATION FORM
Please print this page for your convenience
For any further information or assistance, please contact Nickie
at (310) 546-1226 or you can send an email Nickiedspoons@aol.com
Nickie D., Treasurer,
Spoon Collectors of Southern California
16 Fairway Dr.,
Manhatten Beach, Ca. 90266-7218
Email: Nickiedspoons@aol.com
Spooners Greetings!
Thank you for joining or renewing your membership in SCSC.
Please, complete and return this membership application form together
with your dues to the address of this letterhead. Check payment must be
made payable to SPOON COLLECTORS OF SOUTHERN CALIFORNIA (do not
abbreviate).
Annual Membership dues (in US Dollars) are: Single Person $15.00,
Couple $20.00, additional $3.50 for residents of Canada & Mexico or
$5.50 for residents of any other countries.
Members joining in the middle of the calendar year will have their dues
prorated in the following year.
To be included in the next annual membership roster, this application
along with the dues must be received by no later than December 30th.
MEMBERSHIP APPLICATION
[ ] check here if there are no changes from the previous year
NAME (s):
___________________________________________________________________________
ADDRESS:
__________________________________________________________________________
__________________________________________________________________________
City, St. zip (+4)
_______________________________________________________________________
TELE. NO.__________________________ EMAIL
______________________________________
Type of spoons you COLLECT:
_________________________________________________________________________
Spoons you would like to acquire (heart's desire)
_______________________________________________________________________________________________
Unless requested otherwise, the above information shall appear in
our annual roster and will be distributed ONLY to our other members.
The
undersigned agrees to indemnify and hold SPOON COLLECTORS OF SOUTHERN
CALIFORNIA and its members harmless from any and all liabilities in
connection with all activities, including but not limited to, periodic
meetings and annual conventions.
Signature________________________________________
Date: ___________________________
Signature________________________________________
Date: ___________________________