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Silver Strikers Club Membership Application
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 $10.00. Associate membership for
spouses is available for an additional $10.00.
Make check payable to:
Silver Strikers Club
c/o Cheri L. Jollie
P. O. Box 291537
Phelan, CA 92329-1537
e-mail: membership@silverstrikers.com
