2010 Renewal/Membership Application

 

Please Enroll me in the Horological Association of Maryland, Inc. my $25.00 for annual dues are enclosed.

 

Name..............................................................................

 

Address.........................................................................

 

City....................................... State.........................Zip....................

 

Phone- ................................ Email Address.................................

 

Some Background Information:

Please Check any that apply:

 

Professional......................      Hobbyist.............................

 

Student................................

 

Member of National Organizations:

AWCI..................................       Member #..................................

 

NAWCC.............................       Member #..................................

 

Other..............................................................................................

 

Make $25.00 Checks Payable to

Horological Association of Maryland, Inc.

If Mailing Application, send to:

Mr. Stan Craig, Treasurer

11720 Peacock Trail

Hagerstown, MD 21742

301-739-4441