NAME: _________________________________________________ DATE:_________________

ADDRESS: ______________________________________________________________________

CITY: ___________________________________ STATE: _________ ZIP: _________________

NUMISMATIC INTERESTS: ______________________________________________________

ANA NUMBER: _____________ OTHER AFFILIATIONS: _____________________________

APPLICANT'S SIGNATURE: ______________________________________________________

Dues per	___ $12.50 Regular Membership
calendar year	___ $200 Regular Life Membership
(Check One)	___ $5.00 Junior Membership (under 18)          Date of birth: _______________
	___ $12.50 Club Membership
	___ $200 Regular Club Membership

Send completed application and a check payable to NENA to:

   NENA
   P.O. Box 920586
   Needham, MA  02492-0007