Membership/Renewal Application
(Please
Print)
Name:
___________________________________________________________________
Address:__________________________________________________________________
City: _______________________________ State: _______ Zip:
______________________
Phone: _______________________
E-mail:
____________________________________
Are you joining ___ or renewing ___ (Please check one)
Membership Classes (please check one):
(All memberships include four issues of The Log Train)
____
Regular Member . . . . . . . . . $25
____ Contributing Member . . . .
. $50
____ Supporting Member . . . . . $100
____ Sustaining Member . . . .
. $150
Amount enclosed: _________
Please make your check payable to MSR&LHA and
send it to:
MSR&LHA
c/o Art
Dameron, Membership Secretary
56 Bedford
Pl.
Yardley, PA
19067
USA
Checks must be in US$ and drawn on a U.S.
bank. Send cash
at your own risk.
Sorry, we cannot accept credit cards except for on-line payments made through PayPal.
MSR&LHA is a recognized Section
501(c)(3)
Tax Exempt organization by the internal Revenue Service. All
membership fees and donations are deductible from Federal income tax.