Dakota Postal History Society
P.O. Box 600039
St. Paul, MN. 55106
Application for membership (Please print or type)
Name_____________________________________________
Street Address______________________________________
City__________________________State_____Zip_________
Country______________________________________
Phone (optional): Home____________________Work________________________
Email Address (optional) :_____________________________
(For publication in the bulletin)
Occupation:_________________________________________
Major collecting interest:_______________________________
Other philatelic societies:_______________________________
Have you ever been denied or expelled from any Society? Yes_______No______
If Yes, explain on a separate sheet of paper.
Regular membership is $25.00_______Sustaining membership is $35.00_______
Regular Foreign membership is $40.00_______Sustaining Foreign Membership is $50.00______
Lifetime membership is $350.00 (One time Payment).___________
Electronic Membership is $15.00 (Will receive the Dakota Collector via email in PDF format only)______
Signature______________________________________
Comments or suggestions:________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Continue on another piece of paper if necessary