Club Application and Renewal
Dues are $7.00 per year.
First Name: __________________________
Last Name: __________________________
Member Number: _______________ (for membership renewal)
Address: __________________________________________________________
City: _____________________________________
State: __________________
Phone: ____ _______ - ________________
Email: ___________________________________________________________
Applicants Signature: __________________________________________________
Check or Money Order Number: ______________________________________
You can copy and paste this into your favorite notepad or word software.
Make your check or money order out to Gateway Coin Club of Merced County
Send it to: Gateway Coin Club of Merced County
PO Box 3101
Merced, CA 95344
Merced, CA 95344
Your membership card will be sent by mail to your address given.
