ANA MEMBERSHIP APPLICATION FORM

YES, I want to be part of America's Coin Club. I understand that I will receive the Association's monthly magazine The Numismatist; have access to 30,000 books in the world's largest numismatic lending library; will be eligible for discounts on numismatic books; and obtain dozens of other exclusive member benefits.

Name:	____________________
Address:	____________________ ____________________
City:	____________________
State:	__________
Zip:	__________
Country:	__________
Postal Code:	__________
E-Mail:	___________________
Birth date (MM-DD-YEAR)	___/___/_____
Type of membership (select one): All International Memberships have an additional $36/year shipping and handling fee.	_____ Regular $46 (US - 1 year) _____ Junior $26 17 years or younger (US - 1 year) _____ Senior $41 (US - Age 65 or older - 1 year) _____ Regular $130 (US - 3 year) _____ Life $1200

*Annual membership dues (with the exception of Associate membership) include $20 for a one-year subscription to The Numismatist.

To join by credit card:
Please charge my membership dues of $__________
Credit Card Type:	_____ Visa _____ MasterCard _____ Discover Card _____ American Express
Credit Card No. (all digits):	____________________
Expiration Date (MMYY):	____/____

Signature:	____________________

Periodically, the ANA's mailing list is sold or provided to third parties. If you do not want your information provided to such parties for non-ANA related mailings, please check here. ______.
(Previous requests not to provide your information will continue to be honored.)

Promotion Code _______

I herewith make application for membership in the American Numismatic Association, subject to the Bylaws of said Association. I also agree to abide by the Code of Ethics adopted by the Association.

Primary Sponsor: Dennis Crane - #1211867

Mail or Fax your application to:

American Numismatic Association
818 North Cascade Avenue
Colorado Springs, CO 80903
Fax: 719-634-4085

ANA Membership Rates

Dues Rates U.S.	1 year	2 years*	3 years*	5 years*	LIFE*
Regular Member	$36	$70	$102	$165	$1000
Senior Member (65 & Older)	$31	$60	$87	$145	$750
Club Member	$36	$70	$102	$165	$1,250
Junior (up to 23rd birthday)	$20	$40	$60	$100	$1000
Associate (Spouse of Regular, Senior or Life member and living at same address)	$13	$26	$39	$65	$500

Dues Rates International	1 year	2 years*	3 years*	5 years*	LIFE*
Regular Member	$48	$94	$138	$225	$1,250
Senior Member (65 & Older)	$43	$84	$123	$200	$1,000
Club Member	$36	$70	$102	$165	$1,250
Junior (up to 23rd birthday)	$33	$66	$99	$165	$1,250
Associate (Spouse of Regular, Senior or Life member and living at same address)	$17	$34	$51	$85	$500