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<H1 ALIGN=CENTER>Membership Application<BR>20th Century Railroad Club</H1>
<P>
</P>
<P><I><U><B>Please print this form, fill it out, enclose payment and
mail via postal mail to the club.<BR>Do not send this form via
e-mail.</B></U></I><B><BR></B><BR>All categories of membership
include all members of your immediate family, plus quarterly issues
of "The Fast Mail." Contributing and "Century Club"
members also receive a certificate of thanks and their names
published in "The Fast Mail." The names of "Century
Club" members are engraved on a plaque displayed at our meeting
space.<BR><BR>Please choose a membership category:
</P>
<P>( ) Student - $10 (age 17 or younger) <BR>(
) Regular-$40 per year<BR>( ) Contributing-$75 (or more)
per year<BR>( ) Century Club-$125 (or more) per year<BR>(
) Presidents Club-$250 (or more) per year<BR><BR><BR>Member
Name(s):_____________________________________________________<BR><BR>Mailing
Address:______________________________________________________<BR><BR>City,
State, ZIP Code,
Country:___________________________________________<BR><BR>Home
Phone:_________________________________________________________<BR><BR>Work
Phone:_________________________________________________________<BR><BR>Email:______________________________________________________________<BR><BR><BR>Payment
Method (For your protection, please do not email credit card numbers
to us)<BR><BR>( ) Check/Money Order<BR>( )
Master Card<BR>( ) VISA<BR><BR>Credit Card
Number:_______________________________Expiration
Date:__________<BR><BR>Cardholder
Signature:_____________________________________________________<BR><BR>Please
Print this form and send via postal mail to:<BR><BR>20th Century
Railroad Club<BR>Attention: Membership Secretary<BR>400 E. Randolph
St. Ste. 3725<BR>Chicago, IL 60601<BR><BR>Thank you for your support!</P>
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