MEMBERSHIP APPLICATION/RENEWAL FORM
You may pay membership dues to Friends of Massey (FOM) only or you may include membership dues to Massey Collectors Assoc. (MCA) by indicating your selections below. MCA dues will be forwarded by FOM to the membership secretary of the MCA. (Your FOM Board of Directors recommends that you also join the MCA.)
Please check one of the following:
Friends of Massey Membership
Renewal New
$10.00 Individual = 1 FOM vote $15.00 Family = 2 FOM votes (Husband & wife & children under 18.)
Optional Membership
Massey Collectors Association Membership
$10.00 Individual Membership for 1 year $15.00 Family Membership for 1 year
Note: If you have belonged to the MCA either directly or through another chapter in previous years and are now continuing your membership through the FOM – Check Renewal.
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Check if Address Change
FOM Membership Card requested - enclosed self-addressed envelope
Name:
(If family membership, list names here: (Spouse)
Children under 18:
Address:
City: State: Zip Code:
Email Address: List in Newsletter Do Not List in Newsletter
Telephone Number: ()
Total Amount Enclosed $: Check #: Date:
Make check payable to: "Friends of Massey, Inc."
Mail form and payment to:
Ken Cowher
144 Sherbondy Road.
Jamestown, PA 16134-9602
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