THE NUMISMATIC BIBLIOMANIA SOCIETY

MEMBERSHIP APPLICATION FORM

To join the NBS, simply print the form below, fill it out and return along with a check or money order for your membership dues to:

Numismatic Bibliomania Society
David M. Sundman, Treasurer NBS
P. O. Box 82
Littleton, NH 03561

YES, I would like to join the Numismatic Bibliomania Society. I understand that I will receive the Society's quarterly journal The Asylum.


Standard U.S. MailU.S. 1st ClassOutside of U.S.  Please provide current address, phone & e-mail:
___ 1 Year $15.00___    $20.00 ___ $25.00   outside the U.S.  Name _____________________________________________
___ 3 Years $45.00___   $60.00 ___ $75.00   outside the U.S.  Street _____________________________________________
___ Lifetime $300.00___ $400.00 ___ $500.00 outside the U.S.  City _______________________________________________
Within the U.S., issues will be mailed U.S. Standard Mail, unless you select 1st Class delivery.  State ______________________ Zip Code ________________
      Phone ___________________Email  ____________________


I hereby make application for membership in the Numismatic Bibliomania Society, subject to the bylaws of the organization.

_____________________________________________________
     Signature of Applicant                         Date

Upon successfully joining the NBS, you will receive a valuable back issue of The Asylum - a collectible in its own right- and on publication, the current issue of The Asylum. Make all checks or money orders payable to: Numismatic Bibliomania Society

Return application with payment to:

NUMISMATIC BIBLIOMANIA SOCIETY (NBS)
David M. Sundman, Treasurer NBS
P. O. Box 82
Littleton, NH 03561
Copyright © 1998-2008 The Numismatic Bibliomania Society. All Rights Reserved.