To print a copy of this application, use the print icon in the upper right hand corner of this page. This application will not be converted into an electronic form due to the fact that payment must be sent with the application!

 Phoenix Philatelic Association

P.O. Box 15037

Phoenix, AZ 85060

http://phoenixstampclub.com

 Enclosed find my dues payment for October 2011 through September 2012.

Single               $10.00   ____________

Family              $15.00   ____________

Name ______________________________________

Address ____________________________________

City __________________  State ______  Zip _______

Country __________________________ Email Address _________________________

Collecting Interests ______________________________________________________

 Your name, address, phone number WILL NOT be given or sold to anyone as per our policy.

New Membership cards will be sent upon receipt of dues payment along with a meeting schedule for next year.