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BCCS Membership application form
Please print the following form, then fill in the required information, and return with a check for $15 (payable to
"Barber Coin Collectors' Society") to:
Eileen Ribar
BCCS Membership
2053 Edith Place
Merrick, NY 11566
Name ___________________________________________________
Address _________________________________________________
City ________________________ State _______ Zip ____________
Email: _____________________________________________
Check the description that applies to you: ______Collector ______Dealer
Check the appropriate selection: ______new BCCS member ______returning (former) BCCS member
Sponsored by: BCCS website
My collecting interests: _______________________________________________
__________________________________________________________________
__________________________________________________________________
My name and address may ____ may not ____ be made available to other club members.
My email address may ____ may not ____ be made available to other club members.
Dues = $15.00 per calendar year (Journals shipped first class mail).
Please make checks payable to "Barber Coin Collectors' Society."
_______________________________________ Date: _____________________
Signature
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