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 renewal? { } Yes { } No
May we publish the above information in the club roster? { } Yes { } No
SPONSOR NAME:___________________________________
(If none write Club Webmaster)
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: membership@silverstrikers.com