MSOI Application Form

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If you would prefer to pay your membership online, go to  Join MSOI  and follow the instructions.
For all other forms of payment please complete the following form and post it along with your subscriptions to address below.

Name _________________________________________________

Title (Mr/Mrs/Ms or Rank) ________________________________

EMail Address  ________________________________________

Address ______________________________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________


COLLECTING INTERESTS

_____________________________________________________

_____________________________________________________

_____________________________________________________

I AM A COLLECTOR / DEALER / COLLECTOR-DEALER

(delete as appropriate)

SIGNATURE ____________________________ DATE __________

CHEQUE / DRAFT FOR €_____ / Stg£ _____ US$ _____ ENCLOSED

PLEASE FORWARD COMPLETED APPLICATION FORM TO

PAT CASEY

 "St. Jude's"

57 Wynberg

Blackrock

CO. DUBLIN

IRELAND

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