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Application for Club Membership

 

 

By clicking below you are submitting the information over an unsecured link. Your data is at risk of being captured. The owners of this page are not responsible for lost or stolen data. Submit at your own risk. Sorry for any inconvenience. 

Step 1. Fill out the form:

Do you want us to tell you we have your application?
Yes No

  1. Full Name Last, First, MI:

  2. Address: Line 1

  3. Address: Line 2

  4. City.

  5. State:

  6. Zip Code:

  7. Home Phone Number ###-###-###:

  8. Work Phone Number ###-###-###:

  9. E-Mail: The Southern Kansas City Model Railroaders and it's webmasters guarantee your email address is kept absolutely confidential within the club. It will never be sold to a list service.  Spam activities resulting from your submission here are the result of capture techniques used by hackers. 

  10. Membership type

    Regular: Must be over the age of 18
    Family: Dependants of a regular member
    Affiliate: Should be under the age of 18


    Regular:                  $24.00 Annually

    Family:                    $36.00 Annually including the regular member

    Affiliate:                 $12.00 Annually

By clicking below you understand you are submitting the above information over an unsecured link. Your data is at risk of being captured. 

The owners of this page are not responsible for lost or stolen data. Submit at your own risk.

 

Step 2. Submit the form and wait for a response. Response times will vary from immediate to within 48 hours. 

 

Copyright © 2005 Southern Kansas City Model Railroad Club. All rights reserved.
Revised: March 27, 2005 Rev 9