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Last Name |
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First Name, Initial |
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Street with Apt. Number or P.O. Box |
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City |
State |
Zip or Postal Code |
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E-Mail |
Occupation |
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Type of mailing desired (check all that apply): . . . |
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Philatelic References |
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ICN sent to U.S., Canada: US$ 22.00 |
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ICN sent via airmail outside the United States and Canada: US$ 30.00 |
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Sponsor |
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Membership to begin in 20_____ |
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ICN on CD ROM / Volumes 1-64 (in addition to annual dues) $5.00 (Members) $50.00 (Non-members) PPD. |
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Please make all checks payable to the AMERICAN SOCIETY OF POLAR PHILATELISTS
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AMOUNT ENCLOSED: US $ ___________. Please print and submit this application to the Treasurer: |