Membership Application

MBS MEMBERSHIP APPLICATION

Name -

Address -

City -

State/Province -

ZIP/Mail Code -

Country -

Home phone -

Business phone -

FAX -

email -

	USA	CANADA	OTHER COUNTRIES
Personal Membership (1 or 2 names)	$30	$35	$45
Corporate Membership (Business or institution)	$40	$45	$55

Mail to: Mark Palkovic, MBS Treasurer
620 Clinton Springs Ave.
Cincinnati OH 45229, USA

Enclose dues payment in US dollars drawn on a US bank
or International Money Order in US dollars.
Make checks payable to Miniature Book Society.

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