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RMTC MEMBERSHIP APPLICATION

Annual dues $25.00      ___ New Member      ___ Renewal

Name: _________________________________________________________________________

Street:  ___________________________________  Spouse: _________________________

City: ___________________________   State: _____   Zip+4: __________-__________

Phone - Home/Evening: (     ) _____-_______  Business/Day: (     )_____-_______

Your E-Mail Address: __________________________________________________________

Employer/Employment: __________________________________________________________

Collecting Specialty:  ________________________________________________________

Referred by:  _________________________________________________________________


Please make check payable to:  
	Rocky Mountain Tool Collectors

Mail to:  
 
Richard Juday
4042 Hawthorne Cir, 
Longmont, CO 80503 
richard.juday@gmail.com