American  Historical Print Collectors Society
MAIL-IN MEMBERSHIP APPLICATION

To join or renew immediately (using Paypal, a third-party payment processor, to pay dues), fill out and submit our online membership application.  

For technical problems with this mail-in form, please .  For non-technical problems concerning a new or renewing membership, please .

Please fill out the form below, print it, and mail with your check (payable to AHPCS) to AHPCS, 94 Marine Street, Farmingdale, NY 11735-5605.  Fill out this form exactly as you want it to appear in the membership list.  If you cannot fill out the form online, please print it first, then fill out by hand as legibly as possible.

Your Name
Name (if different) to appear in Membership Directory
Name of institution or business if applicable

Street Address
City State Zip+4 Code

Country
Email address
Telephone

Membership Type
Check the appropriate category.

Collector
Dealer
Institution
Membership Status:
New
Renew

Membership Dues
AHPCS is a not-for-profit, 501 C-3 Federally Tax exempt organization, and any contribution 
above the dues for regular membership is tax-deductible.
 One YearTwo Years
Regular $ 35 $ 70
Contributing $ 50 $ 100
Overseas $ 50 $ 100
Patron $ 75 $ 150
Benefactor $ 100 $ 200
Life $1000  

Primary Interests (Prior to the 20th Century)
For the AHPCS Directory, describe your personal interests or specialties in thirty words or less
OR use the check boxes below.

DO NOT USE IF YOU PROVIDED A DESCRIPTION ABOVE.
Check as many as desired.

(A) Artists
(B) Audubon
(C) Birds
(D) Botanicals
(E) Civil War
(F) Currier & Ives 		(G) Domestic animals
(H) Historic events
(I) Winslow Homer
(J) Industrial
(K) Maps & atlases
(L) Military 		(M) Natural History
(N) Political
(O) Portraits
(P) Publishers
(Q) Rivers and environs
(R) Rural scenes 		(S) Sentimentals
(T) Sporting
(U) Transportation
(V) Views
(W) Western & Native Americans
(X) Any and ALL
Other category (specify)

Last updated February 13, 2007