Littleton Gem & Mineral Club, Inc. Membership Application

Littleton Gem & Mineral Club, Inc. (LGMC)
P.O. Box 283, Littleton, CO 80160-0283
MEMBERSHIP APPLICATION
(PLEASE PRINT)

I/We wish to apply for membership in the Littleton Gem and Mineral club:
(Family membership includes minor children living at home.)

Name ____________________________________ Spouse ___________________________________

Minor Children ______________________ , _______________________ , _______________________

Address _______________________________________________________________________________

City ______________________________________________ , ST _____ ZIP+4 _________ - _____

Phone ______________________ Phone _____________________ Fax _____________________

E-mail ________________________________ Website ______________________________________

Please list your specific interests, such as, mineral or fossil collecting, faceting, cabochons, jewelry making, casting, mining lore, geology, etc.

_______________________________________________________________________________________

Please list any special skills or experiences you may have relating to the mineral hobby.

_______________________________________________________________________________________

For the LGMC to be successful, you are encouraged to participate in its activities and eventually hold a position as officer or committee member. Shared responsibility taps the varied skills of the club's members and lightens the burden of leadership for individuals. Please check those areas below in which you may be able to help in the future (for families, use first names of the adults in appropriate blanks).

________ ________ Executive Board    ________ ________ Membership    ________ ________ Secretarial

________ ________ Field Trips    ________ ________ Newsletter    ________ ________ Shows/Exhibits

________ ________ Financial    ________ ________ Pebble Pups    ________ ________ Web Site

________ ________ Historian    ________ ________ Programs    ________ ________ Other

________ ________ Hospitality    ________ ________ Refreshments

As a member of the Littleton Gem and Mineral Club, I agree to participate in the activities of the club and its leadership responsibilities to the best of my ability. I will share my experience, expertise, and enjoyment of the various aspects of the mineral hobby. I understand the club's purposes and will not exploit its members, meetings, or properties, including mining claims controlled by the club, for personal financial gain or commercial enterprise. I understand that annual membership family/individual fees of $20.00, are due on January 1st, and are delinquent after March 1st and that membership fees are reduced by 50% for those who join after August 31st.

I have included a check for $ ____________

Signature _________________________________ Signature _________________________________ (Spouse, if family application) Approved by Board Action:
Signed _________________________________
Date ____________________

Hosted by www.Geocities.ws

________ ________ Executive Board	________ ________ Membership	________ ________ Secretarial
________ ________ Field Trips	________ ________ Newsletter	________ ________ Shows/Exhibits
________ ________ Financial	________ ________ Pebble Pups	________ ________ Web Site
________ ________ Historian	________ ________ Programs	________ ________ Other
________ ________ Hospitality	________ ________ Refreshments