FFCA Membership NEW/RENEWAL

Membership NEW Membership        RENEW Membership

Membership #

Name #1

Date of Birth

Name #2

Date of Birth

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code      Country

Home Phone

Work Phone        FFCA Dues $35/yr

FAX

E-mail

URL

My/Our favorite Frankoma to collect . . .

My/Our Preferred FFCA Membership Directory Listing

Method of Payment

Check Number       Check Amount

VISA       MasterCard

Please charge to my credit card

Credit Card Number

Expiration

V-Code Number
V-code is the last 3 digits after your card number on the back side
of your card just above your signature

Signature

Complete form, print, and mail along with your check/money order to:

FFCA, PO Box 32571, Oklahoma City, OK 73123-0771

Make Check Payable to: FFCA

You are visitor

Please come again!

A national non-profit organization dedicated to the appreciation, preservation, and promotion of Frankoma Pottery as a collectible.

Membership	NEW Membership RENEW Membership
Membership #
Name #1
Date of Birth

Name #2
Date of Birth
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code	Country
Home Phone
Work Phone	FFCA Dues $35/yr
FAX
E-mail
URL

Method of Payment
Check Number	Check Amount

	VISA MasterCard
	Please charge to my credit card
Credit Card Number
Expiration
V-Code Number		V-code is the last 3 digits after your card number on the back side of your card just above your signature
Signature