Lone Star Chapter 124, NAWCC

Chapter Membership Application/Renewal Form

Print this application for use.


Membership is only $10 per year. You may join for 1 to 5 years at that rate.
Complete & send with a check made payable to

Lone Star Chapter #124

Mail to: Gene Meysenburg, Lone Star Chapter 124, 11028 Creekmere, Dallas, TX 75218.


Please check the Appropriate box: _____ New #124 Member _____ Renew my Membership

Enclosed is a check for $_______ for _______ Years ($10 per year)..

To join Chapter #124 you must be a NAWCC member, or have applied for NAWCC membership. If you have applied for National membership, but haven't received a membership number, Check here______, [Date of your application/check to National____________.]

Mr____ Mrs____ Miss____ Ms____(Please check appropriate blank)

Name:____________________________________________NAWCC#:___________



Street: _________________________________________ Phone:_______________



City:_________________________________ State: ______ Zip:________

Email Address: ______________________________________________



Do you want certain Newsletters to be delivered via Email? ______ (Yes or No)

Horological Interests: _____________________________________________________

   _______________________________________________________________________



Who recommended you? Name: _________________________ NAWCC#:___________


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