Associated Collectors of
Planters® Peanuts Memorabilia
APPLICATION FOR MEMBERSHIP
Annual dues are
$20.00 for primary members. Dues for associate memberships are available for
$10.00, age 16 and older. For other
individuals of the primary member’s family, under the age of 16, dues are
$3.00. Newsletters and other
mailings are sent to primary members only.
Use the “File” then “Print”
button on your browser to print out a copy of this form.
Fill it out, enclose a check
and mail to:
Peanut Pals
P.O. Box 113
Nesquehoning, PA 18240
Name (Primary Member) __________________________________________$20.00
Address _____________________________________________________________
City __________________________ State ___________ ZIP Code _____________
Phone __________________________________ Country _____________________
Associate Member @ $10.00 Each (16 or older) @ $3.00 Each (15 or younger).
Name_______________________________________________________ $______
Name_______________________________________________________ $______
Name_______________________________________________________ $______
Total Amount Enclosed (In U.S. Currency)--------------------------------------$______
Make
Check / Money Order Payable to Peanut Pals
Checks / Money Orders must be in U.S. Funds, Payable through a U.S. bank or post office.
Permission to List Name and Address in the Directory? YES______ NO______
Permission to List Phone Number in the Directory? YES______ NO______
Permission to publish your e-mail address in the Directory? YES______ NO______
Your e-mail address is?_________________________________________________
How did you first hear about Peanut Pals? __________________________________