PO Box 11192, Tacoma, WA 98411, phone 253-565-6565, fax 253-851-8632
Also see application in PDF format (convenient to print).

Check type of membership for which you are applying:
__ Individual (annual dues $8), __ Junior (annual dues $2)
__ 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: ____________