CROATIAN PHILATELIC SOCIETY
               P.O. Box 696, Fritch, Texas 79036-0696
		   E-Mail: spahich@hotmail.com
			
		     Membership Application


Name_______________________________________ Age_____________________


Street or Box_______________________________________________________

                            State or
City_______________________ Province ___________ Zip________________

               
E-Mail address:_____________ Date and place of birth _______________


Do you wish to be listed in the Directory? ___ Are you a Dealer?____


I collect: 

Stamps:__ Coins:__Currency:___Medals:___History:___Other:__________


Croatia________________         Bosnia and Herzegovina_____________

Slovenia_______________         Fiume (Rieka)______________________

Macedonia______________         Albania____________________________

Montenegro_____________         Trieste (Zone A & B)_______________

Serbia_________________       	Yugoslavia_________________________

Kosova_________________		Romania____________________________

Bulgaria_______________		Zara (Zadar)_______________________

Austria________________		Hungary____________________________


(List any other interests on the reverse of this form or on separate
sheet of paper. Also, other Stamp, Coin Club, History and related 
Memberships, including the membership number:______________________

___________________________________________________________________

___________________________________________________________________


The fiscal year ends Oct. 31st.  Dues are $24 per year for all 
countries. Please remit dues with application per table below:

	November-April $24	May-October $26

By remitting the correct amount, dues will be paid to 31 October
200_.  Your membership fee includes a free subscription to 
THE TRUMPETER, society's journal. Please make remittance payable to 
the Croatian Philatelic Society. Dues are payable in U.S. funds.


Applicant's signature_________________________________ Date_________
***********************FOR CPS**************************************

Membership Number________ Date _________ Recommendedd By ___________