LATIN AMERICAN PAPER MONEY SOCIETY
SOCIEDAD LATINOAMERICANA DE PAPEL MONEDA

3304 MILFORD MILL ROAD
BALTIMORE, MD 21244 U.S.A.

MEMBERSHIP APPLICATION - SOLICITUD DE SOCIO

(Please Print / Letras de molde)

Name / Nombre _________________________________ Date / Fecha______________

Address / Direccion ______________________________________________________
_______________________________________________________________________
_______________________________________________________________________

Email_______________________________
Website______________________________________________

Collecting Interests / Colecciono ____________________________________________
_______________________________________________________________________
_______________________________________________________________________

Languages / Idiomas:

Write / Escribo_____________________________________________

Read / Leo__________________________________________________

___ Collector / Coleccionista ___ I send price lists / Envio Listas de precios
___ Dealer / Comerciante___ I accept want lists / Acepto mancolistas

I am applying for membership - Solicito se me acepte como socio

Signature / Firma ________________________


Membership Dues: US$ 10.00 year / aņo Cuenta Social

(Please pay your dues by check or money order on a U.S. bank; cash; or current uncirculated bank notes at the official exchange rate.)
(Favor de remitir por cheque o giro postal contra banco de los Estados Unidos; en efectivo; billetes corrientes a la tasa de cambio oficial.)


Pease send to - Por favor envie a:

Arthur C. Matz, 3304 Milford Mill Road, Baltimore, MD 21244, U.S.A.