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I hereby make application for membership in the Missouri Numismatic Society subject to the by-laws of said Society. Mr./Mrs./Miss:________________________________________________________________________ Name (please print) ____________________________________ __________________________ __________ __________ Street Address City State Zip Spouse: ____________________________________________________________________________ Children: ___________________________________________________________________________ Telephone No: Home: ______________________________ Business: ________________________ Email Address: ________________________________________________________________ Numismatic Topics of Interest: _________________________________________________________ ___________________________________________________________________________________ Type of Application: Family / Junior (under 18 years) (Please circle type) Are you a former member? ______________ If so, what was your old number? ____________ I, ____________________________________________________ do solemnly pledge that I will exert my Signature of Applicant influence and lend my aid to promote and advance every interest of the Missouri Numismatic Society: to uphold its by-laws and perform all imposed duties consistent with it and to attend meetings whenever possible. I further pledge that I will not cheat or defraud any one engaged in the hobby of Numismatics; that if I am accused thereof, and such charges are substantiated after due process of the applicable procedure established in the Society’s by-laws, it will be just cause for my expulsion from the Society. Date of Application: _____________________ Membership Date Accepted: _____________________ Number: _________________________________ (For use of Secretary) (For use of Secretary) Send Application and check for $10.00 (for Family Membership) or $2.00 (for Junior Membership) to
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