Tin Pedlar of Maine Membership Form

Please print clearly.

Date:

Name:

Address:

Town/City:

State:

Zip code:

Telephone (cell or home):

E-mail:

Please send this form, along with dues of $20 ($25 after the October meeting), made payable to: Tin Pedlar of Maine, to: Rachel Jones, 910 Methodist Rd., Westbrook, ME 04092.

You may also pay at the September or October meetings.


 

ATHA Dues are payable directly to ATHA on your anniversary date (which is found on your mailing label when you receive your magazine). You can pay online by using PayPal or by check using either the form within the magazine or below here. Tin Pedlar of Maine will also forward your payment with the completed form, if you so choose.

ATHA Membership/Renewal Form

Name:

Phone:

Address:

City:

State:

Zip code:

E-mail:

May ATHA publish your e-mail in our membership directory?     _____ yes   _____ no

E-mail and street addresses are used for ATHA business ONLY!

Dues are $26.00 annually, payable to ATHA.

Mail to: Joan Cahill, 600 1/2 Maple St., Endicott, NY 13760

Circle all that apply:  student     supplier     teacher     new member     renewal

Date:

If you are a member of an ATHA chapter, write the name here: Tin Pedlar of Maine


 

For a version of this form to download for printing click here.

 

 

 

 

Advertisements