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SILVER STRIKERS CLUB APPLICATION
(Select this link For Printable Application Form)MEMBERSHIP APPLICATION
SILVER STRIKERS
Name ______________________________
Address ____________________________
City _______________________________
State _________________ Zip _____-____
Phone ______________________________
E-Mail ______________________________
My areas of interest are:
{ } All { } Atlantic City
{ } Nevada { } Riverboats
{ } Colorado Other _____________________
Denominations I collect are:
{ } All { } $2 { } $3
{ } $7 { } $10 { } $12
{ } $20 { } $28
{ } $40 { } $200 Other _____________________
Check Here if this is a your annual renewel? { } Yes { } No
May we publish the above information in the club roster? { } Yes { } No
SPONSOR NAME:___________________________________ (If none write Jim Moser)
Do you want the club newsletter e-mailed to you?(no extra cost) YES___ NO____
If yes, e-mail address to send it to. _____________________________________
Mail completed application with your first year dues of $15.00 and a one time new member processing fee of $8.00 . Associate membership for spouses is available for an additional $15.00 .
Make check payable to:
Silver Strikers
c/o Leroy Rico
98-1617 Hoomaike Street
Pearl City, HI 96782-2332
e-mail: ricoL001@hawaii.rr.com
This document maintained by Jim Quinn
SilverStrikers@yahoo.com
Material Copyright © 2008 Silver Strikers Club