Lone Star Chapter 124, NAWCC
Chapter Membership Application/Renewal Form
Print this application for use.
Membership is only $10 per year. You may join for 1 to 5 years at that rate.
Complete & send with a check made payable to
Lone Star Chapter #124
Mail to: Gene Meysenburg, Lone Star Chapter 124, 11028 Creekmere, Dallas, TX 75218.
Please check the Appropriate box: _____ New #124 Member _____ Renew my Membership
Enclosed is a check for $_______ for _______ Years.
To join Chapter #124 you must be a NAWCC member, or have applied for NAWCC membership. If you have applied for National membership, but haven't received a membership number, Check here______, [Date of your application/check to National____________.]
Mr____ Mrs____ Miss____ Ms____(Please check appropriate blank)
Name:____________________________________________NAWCC#:___________
Street: _________________________________________ Phone:_______________
City:_________________________________ State: ______ Zip:________
Email Address: ______________________________________________
Horological Interests: _____________________________________________________
_______________________________________________________________________
Who recommended you? Name: _________________________ NAWCC#:___________
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