Membership Application - Print this page and fill it out
	Casino Chips and Gaming Tokens
	Collectors Club

        Name _________________________________________

        Address_______________________________________

        City___________________________________________

        State, Zip (Country)____________________________

        Phone_________________________________________

               My Collection interest Are:

               {  }  Chips          {  }  Tokens
               {  }  U.S.           {  }  Foreign

                   I would Like you to Publish my.....

               {  }  Name and Address
               {  }  Phone
               {  }  Do Not Publish my Name and Address
     
                   I have enclosed my Annual Dues for:

               {  }  One Year                  ($20)  U.S.
               {  }  One Year First Class      ($32)  U.S.
               {  }  Two Years                 ($40)  U.S.
               {  }  Two Years First Class     ($64)  U.S.
               {  }  Associate                 ( $5)  U.S.
               {  }  Foreign                   ($30)  **
                  ** Postal money order or U.S. Funds

               {  }  Membership Directory      ( $5)  U.S.
     
               Amount Enclosed {$                  }

     Foreign Mailings are at the First Class rate all other mailings are via
3rd Class Mail. 

	Annual dues will be renewable in the same quarter in which the
membership application was processed.  Check our address labels for your
membership expiration dates.  Mail your completed application with your check
made payable to CC>CC, to:

	James Steffner
	CC>CC-RECORDING SECRETARY
	P.O. BOX 368
	Wellington, OH  44090
	SPONSORED BY:  Marvin Weaver R-1014