Join the Club

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

Your membership card will be sent by mail to your address given.