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Iran Philatelic Study Circle
Membership Application
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Print this form, fill out and sign, and include a check for US $20.00 or UK £10.00 as indicated below and mail to the USA address if you are in the US, for UK or the rest of the world use the UK contact information:
Your application will then be processed by the secretary of the respective chapter. |
I am interested in joining the Iran Philatelic Study Circle and provide the following information in support of my application .
Full name: ______________________________
Mailing address: This address will be published in the Bulletin.
______________________________
______________________________
______________________________
______________________________
Age if under 18: __________
E-mail address: ______________________________
Introduced by: ______________________________
Or, if not introduced by a current member, how did you hear of the Study Circle?
______________________________
I am a member of the following philatelic societies:
______________________________
______________________________
I wish to join the:
___ UK Chapter. Submit check drawn on a UK bank for £10.
___ US Chapter. Submit a check drawn on a US bank for US $20.
Signature: ______________________________
Date: ______________________________
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