| ____ |
Please tell me more
about the NRHS and about nearby chapters I can join. |
| ____ |
Also please send me
a sample copy of the NATIONAL RAILWAY BULLETIN.
I'm enclosing $1.00 for postage. |
| ____ |
Enroll me as an At-Large
Member for one year. I'm enclosing US $37.00. |
| |
____ Enroll my family
member(s)/spouse as well for an Additional $5.00
per person. |
| ____ |
Enroll me as Student
Member (ages 13 - 18) for one year. I'm enclosing
US $16.00. |
| |
____ Enroll my family
member(s)/spouse as well for an Additional $5.00
per person. |
| ____ |
Enroll me as Youth
Member (ages 5- 12) for one year. I'm enclosing
US $5.00. |
| |
____ Enroll my family
member(s)/spouse as well for an Additional $5.00
per person. |
| First
Name: |
________________________________________________ |
| Middle
Name: |
________________________________________________ |
| Last
Name: |
________________________________________________ |
| Address
1: |
________________________________________________ |
| Address
2: |
________________________________________________ |
| City: |
________________________________________________ |
| State/Province: |
________________________________________________ |
| Zip/Postal
Code: |
________________________________________________ |
| Country: |
________________________________________________ |
| Phone
Number: |
________________________________________________ |
| Email
Address: |
________________________________________________ |
| Family
Member Name (if joining): |
________________________________________________ |
|
Signature:
(if joining)
|
_________________________________________________ |
Family Member Signature:
(if joining) |
_________________________________________________ |