JPS Membership Form

Jackson Philatelic Society (https://jacksonphilatelicsociety.org )

P. O. Box 16792

Jackson, MS 39236-6792

APS chapter # 831

Membership Application

(Please print clearly)

Name (last, first)_____________________________________ Age____________

Occupation_____________________ Mailing Address_______________________________________________________

City__________________________State______________Zip Code________________

Tel. NO: _______________________E-mail___________________________________

Mailing Address______________________________________________________

City, State____________________________________ Zip Code_______________

Tel. No.: Home_________________ e-mail ________________________________

Membership requested: Individual____ Family____ Children under 18 (number) ____

American Philatelic Society (APS) member? Yes___ No___ If yes, membership No. ______

Other philatelic societies to which you belong _____________________________

_____________________________ ___________________________________

Philatelic interests _____________________________________________________________________

Signature_____________________________ Date____________

Please, mail completed form and dues payment (yearly Individual: $5; Family: $ 10; children under 18 years: none) to the Jackson Philatelic Society address at the top of this form.

For APS office use only

Date application received___________________ Copy to: ( ) Treasurer

Membership proposed by:___________________ ( ) Secretary

1st reading of Application ___________________ ( )