Print out and complete this membership application, enclose your check or money order for the appropriate amount
payable to the Collins Collectors Association and mail it to:
The Collins Collectors Association
P. O. Box 354
Phoenix, MD 21131
Your membership certificate, welcome letter and a copy of the most recent issue of the Signal newsletter will be mailed to you.
Please allow 2-5 weeks for processing.
Name: ____________________________________________________________________
Amateur Call:
__________________ _______ License Class: _____________________ Street or P. O. Box: _________________________________________________________
City: ______________________________________ State: _________ Zip: ___________
Country (outside USA):
_____________________________ Telephone: ____________________________________
E-mail: ________________________________________ Third-Party suppliers would like to provide CCA members with useful, Collins related product
information. Do you want to receive offers from CCA approved suppliers via postal mail? Yes____/No____
Do you want to receive offers from CCA approved suppliers via E-Mail? Yes____/No____
_____________________________________________________________________________
Office use only:
Date received ________________ Received by _________________ Date processed ____________ |
