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Pacific Northwest Numismatic Association
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If not using PayPal, please complete and return this section along with your check or money order payable to the PNNA and mailed to Rachel Irish at the address listed above.
Application date: ________________
__ Individual ( __ annual dues $10, __ 3-year dues $25)
__ Family ( __ annual dues $15, __ 3-year dues $37.50)
__ Young Numismatist up to age 21 (annual dues $5; proof of age may be required)
__ Life ($200; individuals only)
__ Club ( __ annual dues $15, __ 3-year dues $37.50, __ 10-year dues $100)
__ NEW __ RENEWAL __ UPGRADE
Please type or print:
Name: ________________________________________________________________
Address: ________________________________________________________________
City/state/ZIP: ________________________________________________________________
Phone (with area code):
__________________________________________
e-mail address (optional):
__________________________________________
I'd like to see the PNNA do the following:
____________________________________________________________
_______________________________________________________________
_______________________________________________________________
PNNA use only:
Amount received: $__________ Membership # __________
Date assigned __________
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