NENA Membership Application
NEW ENGLAND NUMISMATIC ASSOCIATION
MEMBERSHIP APPLICATION
(please print clearly)
NAME: _______________________________________ DATE:_________________
ADDRESS: __________________________________________________________
CITY: __________________________ STATE: _________ ZIP: _________________
EMAIL: ______________________________________________________________
PHONE: _____________________________________________________________
NUMISMATIC INTERESTS: ______________________________________________
ANA NUMBER: ____________ OTHER AFFILIATIONS: ________________________
SPONSORING CLUB (IF APPLICABLE): ____________________________________
APPLICANT'S SIGNATURE: _____________________________________________
| Dues per | ___ $15.00 Regular Membership |
| calendar year | ___ $200 Regular Life Membership |
| (Check One) |
___ $5.00 Junior Membership (under 18) Date of birth: _______________ |
| ___ $15.00 Club Membership | |
| ___ $200 Regular Club Lifetime Membership |
Send completed application and a check payable to NENA to:
Robert F. Fritsch, Membership Director
P.O. Box 3003
Nashua, NH 03061-3003
NENA News, a quarterly publication of the New England Numismatic Association is included with membership.