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**Please Print Out and Mail With Membership Fee**

Membership Application

Miniature Piano Enthusiast Club

MEMBER BENEFITS
Four newsletters: Musically Yours!  A Personalized Membership Card, Free Gift, The opportunity to develop friendships with other collectors, view collections, and enjoy common interest .

Opportunity to attend annual conventions.

Name:____________________________________________________________

Address: ___________________________________________________________

City:_________________________State:_____ Zip:________Country:__________

Phone: __________________________ Fax: _______________________________

E-Mail address: _______________________________________________________

How did you learn of the MPEC?__________________________________________

Length of time collecting?________________________________________________

Size of Collection? _____________________________________________________

Birthdate – Day & Month?_______________________________________________

[  ] YES to list name, address & phone number in newsletter; [  ]  No – do not list

MEMBERSHIP DUES:

• U.S. members - $15.00 per year
• Canada - $15.00 per year (Checks or Money Orders must be on U.S. Funds)
• All Other International - $15.00 per year  (Checks or Money Orders must be on U.S. Funds)

Annual membership period is April 27^th through March 31^st of the following year.
(1/2 year membership – September 27^th – March 31^st is $7.50)
Dues Renewal letters are sent on April 1^st.
.........................................................................

Payable to: Miniature Piano Enthusiast Club ......U.S. funds only.........

Amount enclosed $________

Mail to:
Janice E. Kelsh, Miniature Piano Enthusiast Club, 633 Pennsylvania Avenue, Hagerstown, MD  21740
 g.................

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