FRANCE AND COLONIES PHILATELIC SOCIETY, INC.

 

MEMBERSHIP APPLICATION

 

I hereby apply for membership in the France & Colonies Philatelic Society, Inc., and enclose dues for the first year, as indicated:

 

 

_ _ _ _ _

Resident of the United States

$20.00

_ _ _ _ _

Resident of any other Country

$25.00

 

 

                                                Signature  _________________________________

 

 

Please supply the following information for the Membership Committee and complete the Speciality Questionaire on the reverse side of this form for listing in the PHILATLEIST.

 

            NAME____________________________________________              AGE ________

            ADDRESS ____________________________________________________________

            CITY _______________________________            STATE________________________

            POSTAL CODE ______________________            COUNTRY _____________________

            TELEPHONE ________________________       e-mail _________________________

 

 

Membership in other philatelic groups:

 

            Organization ______________________________   Membership No. _____________

            Organization ______________________________   Membership No. _____________

 

Reference (Stamp dealer; other FCPS member, etc.)

 

            NAME ______________________________________________________________

            ADDRESS ___________________________________________________________

 

 

From whom did you learn about the FCPS? ________________________________________

 

Payment by residents of the United States is to be made in U.S. dollars via a check drawn on a U.S. bank or via a U.S. Postal Money Order. Foreign memberships can be paid via an International Money Order. Payment in foreign currency must include the equivalent of U.S. $10.00 extra per transaction to cover the conversion to U.S. funds.

 

            Pay To:             FRANCE AND COLONIES PHILATELIC SOCIETY, INC.

 

            Mail To:       Joel L. Bromberg

                                    P.O. Box 102

                                    Brooklyn, New York 11209-0102

USA