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Antique Coin Machine Collectors Association

 

Application for Membership

Name:___________________________________________

 

Business Name:___________________________________

 

Address:_________________________________________

 

City:____________________________________________

 

State:___________________________________________

 

Zip:____________________________________________

 

Phone:__________________________________________

 

E-mail:_________________________________________

 

Annual membership dues are $24.00, payable on October 1st. New membership is pro-rated at the rate of $2.00 per month from the first day of the upcoming month thru October 1st. Please mail your check with the correct amount only (payable to ACMCA) together with this application.

 

 

Mail to:

ACMCA

 

John Disalvo, Treasurer

 

340 Walnut

 

Arcadia CA 91007

 

626-445-8414