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New
Member Application
Today's Date:
______/______/______
Membership Type: _____ Regular/Annual Member - $25.00
_____ Young Numismatist (under
18) - $7.50
Mailing Options: _____ U.S. Bulk rate - No extra charge
_____ First Class or Foreign
- $12.50 additional
Total: _____ Amount Due
Name: _______________________________________________________
Address: _______________________________________________________
City: _______________________State: ______Zip + Four Code: __________
Phone: _______________________________________________________
E-mail: _______________________________________________________
Recommended by:
Variety Vista
Comments/Interests:
________________________________________________________________
________________________________________________________________
Send application and check/money order (payable to CONECA) to:
BJ Neff
321 Kingslake Dr.
Debary, FL 32713
Your membership is subject to approval by the Membership Committee
and subject to the rules and regulations set forth in the CONECA
Constitution and By-Laws.
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