SCSC APPLICATION FORM

For any further information or assistance, please contact Andrew Kwiat
email: Sonand@aol.com or Tel. (310) 253 9922

Nicki 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


NAME (s): ___________________________________________________________________________
 
ADDRESS: __________________________________________________________________________
 
                   __________________________________________________________________________
 
TELE. NO.__________________________    EMAIL ______________________________________

COLLECTS: _________________________________________________________________________
                
Unless requested otherwise, the above information shall appear in annual roster and will be distributed to all the 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: ___________________________