PNC3 Membership Change of Address Form

Please change my address and/or email in the records of the Plate Number Coil Collectors Club (PNC³).

Name: Membership Number:

Old Address:
Old City: Old State/Country: Old Zip Code:

New Address:
New City: New State/Country: New Zip Code:

Daytime Phone: Evening Phone:
Fax: E-Mail Address:

Comments

I would like the Secretary to confirm receipt of this form.Yes No

(Start Over) (Send Copy To Secretary)

If you wish, you may print out a copy of this form and send it to our Secretary, Daniel Farrar, 3386 Excalibur Cr., NW, Canton, OH 44708-1143.

FOR CLUB USE ONLY Date Received ________________ Member Number _________________________