Application for Membership
in the
Texas Numismatic Association, Inc.

I herewith apply for membership in the Texas Numismatic Association, subject to the association’s Articles of Incorporation, By-Laws, and other rules and regulations, and tender $___________ for dues.

Mr., Mrs., Miss.,______________________________________________ Date___________
                                   Type or Print Name as you want it on Roster

___________________________________________________________________________
                                                           Business Name or  d.b.a.

Street or P.O. Box_____________________________________________________________

City _______________________________________State _______Zip___________________

eMail_________________________________________ Phone#________________________

Under 18 yrs. of age__________18 or over _______________

Applying for:
Regular________ Associate__________ Junior_________ Chapter________

___________________________________________________________________________
                                                              Collecting Interest

___________________________________________________________
            Signature of Applicant

___________________________________________________________
             Junior Applicant: Signature of Parent of Guardian

______________________________________TNA#________________
            Signature of Proposer

TNA Dues:

Please Mail Completed Application To:

Texas Numismatic Association
Hal Cherry (Secretary)
P O BOX  852165
Richardson, TX  75085-2165