Tacoma-Lakewood Coin Club

TLCC is a non-profit corporation registered in the State of Washington.
Address: TLCC c/o Todd Hughes, 1910 East 4th Ave #41, Olympia, WA 98506.
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Tacoma-Lakewood Coin Club MEMBERSHIP APPLICATION

Please mail applications to Todd Hughes, 1910 East 4th Ave #41, Olympia, WA 98506.

Also see application in PDF format (convenient to print).

Check type of membership for which you are applying:
__ Individual (annual dues $10), __ Junior (annual dues $4.00)
__ New __ Renewal __ Upgrade

Please type or print:
Name: ________________________________________________________________
Address: ______________________________________________________________
City/state/ZIP: __________________________________________________________
Phone (with area code) (optional): __________________________________________
e-mail address (optional): _________________________________________________
Parent or Guardian (for juniors): ____________________________________________
Collecting Interest: ________________________________________
How did you hear about us? _________________________________
Signature _______________________________________________

I'd like to see the TLCC do the following:
___________________________________________________________________________
___________________________________________________________________________

TLCC use only:
Proposed by: ___________________________
Dues paid: $____________
Admission date: ____________
Membership # __________

Date of first reading: ____________
Date of second reading: ____________
Date approved: ____________