Australian Match Cover Collectors' Society
Membership Application Form

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To Subscribe, print this page and send it to:

The Membership Secretary
13 Midvale Avenue
North Balwyn
Victoria, Australia 3104

To the Committee,
I wish to apply for ADULT/JUNIOR/ASSOCIATE membership of the A.M.C.C.S. and, if accepted to abide by the rules of the Society.

Name............................................................... Mr/Mrs/Miss

Address:
Street...........................................................................
Town...........................................................................
State............................................Postcode..................
Country, (If not Australia) ............................................

BLOCK

LETTERS

PLEASE

The following information is required in order that member's phillumenic details and interests can be included in the membership lists.
I collect (Tick if applies)

Labels [ ] Packet Labels [ ]
Skillets [ ] Booklets [ ] Hardware [ ]

No. of items in collection: Labels.................. Booklets..................
I specialise in (e.g. country, theme, etc.) ......................................
Are you willing to exchange with other members? Yes [ ] No [ ]
I am able to correspond in the following languages: .........................
.........................................................................................

I enclose $................. in payment of my membership fee

If you are applying for membership as a Junior, please give your date of birth and request your parent to sign this form.

Date of Birth.........................................
Signature............................................... Date............................

If you require a Society Badge, please enclose an extra $2.00,
and tick here [ ]