Louisiana Numismatic Association

 P.O. Box 7213
 Metairie, LA  70011

Application for Membership

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Print Your Name

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Mailing Address

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City, State  Zip

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(Area Code) Phone Number                                             E-mail Address

I hereby apply for membership in the Louisiana Numismatic Association subject

to the Association’s Constitution and By-Laws and tender $ ________ dues.

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Collecting Interests 

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Signature Of Applicant                                                                          Date

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Signature of Parent or Guardian for Junior Membership                  Date

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Recommended by                                                                                   Date

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To be completed by LNA Secretary

Dues Received: $________________________   Date: ____________________

LNA District #: _________________  LNA Member #: ___________________

Approved: _______________________________________________________

                  President                                                                                Date