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Please select one:     New Membership          Membership Renewal

Name     Age  

Auxiliary Member's Name 

Address  

City     State    Zip + 4   - 

Country    E-mail  

Phone      I want to be listed in the CMB membership roster. 

I authorize the CMB to put my phone number in the membership roster.  

I authorize the CMB to put my e-mail address in the membership roster.  

Please list the scale(s) you model in. (Z, N, HO, O, O27, G, etc.) 

Dues From January 1 to December 31

New members recieve all this years issue of the LCW

Regular Membership (U.S.A. Canada, Mexico)   $40.00
Auxiliary Membership(relative of member or other interested person. Non-voting, does not recieve LCW)     $5.00
Student Membership (16 up to 20 years of age, full time student) WITH LCW   $30.00
Junior Membership (8 up to 16 years of age) WITH LCW   $25.00
Family Membership(Adds voting spouse/partner and all family members under 16 years of age to one of the above memberships, recieves one LCW)
Add $10.00		 +$10.00
International MembershipAddresses outside of U.S.A., Canada, Mexico
Except for Auxiliry, add $15.00 to above to cover overseas postage		 +$15.00


Contributing Membership (includes regular dues & 1st class mail for LCW)
WAGONMASTER $50.00
INTERNATIONAL WAGONMASTER $65.00
RINGMASTER $65.00
INTERNATIONAL RINGMASTER $75.00

OPTIONAL
CMB Advertising Fund $             
CMB Promotional FundIn Memory of (optional)                             $             
Other DonationsIn Memory of (optional)                             $             
 
Total Enclosed
$             

Payments accepted in US funds only - drawn on US banks only - payable to Circus Model Builders, Inc.

If you are a current member of the CMB please enter your CMB number in this box  


Membership incentive: If you were recruited by a CMB, please provide the name and CMB number of the person who recruited you.

I was recruited by   CMB #  




  		 Using the schedule above,please send check or money order to:

Ron Hurst, Secretary
Circus Model Builders, Inc.
4724 W Pendleton Place
Peoria, IL 61615-2841

If you are a current CMB member, please put your
CMB # on your check or money order.

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