2010 DUES INVOICE & MEMBERSHIP DIRECTORY UPDATE FORM

Mail to: DISCOUNTED DUES FOR 2010 IF PAID

Antique Fan Collectors Assoc.
Dick Boswell, Treasurer
2245 Harrison Ave.
Lincoln, NE 68502
BEFORE JANUARY 31, 2010
Discount Rate After 1/31/10
Regular (North America) Members $45.00 $50.00
Junior (under 18, North America) $20.00 $25.00
Foreign (outside North America) $70.00 $70.00(US)

Please remit the proper amount, payable to Antique Fan Collectors Assoc., and return with this form.

Check here for Renewal [ ] Very First Time Membership [ ]

THE FOLLOWING INFORMATION WILL BE YOUR LISTING IN THE MEMBER-

SHIP DIRECTORY. Whether you are renewing or a new member, you must fill
in the following as you wish to have it listed. — WHAT YOU LEAVE BLANK
WILL BE BLANK IN THE NEW DIRECTORY FOR 2010.

Member’s Name_______________________________________________________________

Spouse’s Name________________________________________________________________

Address______________________________________________________________________

City____________________________________ State_________ Zip____________-________

Home Phone (_____)____________________Work Phone (_____)_______________________

Cell Phone (_____)________________________Fax Number (_____)____________________

E-mail Address________________________________________________________________
( If you want your email address listed on the website check here [ ]

Collecting fans since____________

Other areas of interest___________________________________________________________

The following information may be provided if you wish.

Occupation (if retired, from what?)_________________________________________________

How did you hear about the A.F.C.A.?______________________________________________

Favorite fan___________________________________________________________________

In which areas can you assist the A.F.C.A.?__________________________________________

What time of year is best for you to attend FanFair (our national annual convention)?_________