I hereby make application for membership in the

LONE STAR MATCHCOVER CLUB

Enclosed is $7.50 US (individual/hard copy bulletin); $5 (individual/e-bulletin); $8.50 (family/overseas) for the first year's dues.
 
Name:______________________________________________ Date___________
 
Adress:_____________________________________________________________
 
City:____________________________ State__________ Zip_________________
 
Birthday (mo/day)_______________E-mail address_________________________
 
Signature____________________________ Phone_________________________
 
Sponsored by___________________________ General collector?_____________
 
Briefly list your six favorite collecting categories:
 
1.___________________ 2._____________________ 3.____________________
 
4.___________________ 5._____________________ 6.____________________
 
Please mail your application and first year's dues to:
 
LaJuan Melendy, Membership Secretary
Lone Star Matchcover Club
10506 Trinity Springs Dr., Cypress, TX 77433