Central Indiana Division
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NMRA and Midwest Region Membership Application
Mail to: NMRA Inc. Fax to: (423)899-4869
4121 Cromwell Rd.
Chattanooga, TN 37421
- I enclose... (check option below)
- __check (payable to NMRA Inc.) __Money Order __Charge
Charge to:
__MasterCard __VISA __American Express __ Discover
Expiration Date ____________________________
Card # __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Signature_____________________________________________________
I wish to join as... (check option below)
- Student - All Rights & Benefits and Scale Rails
Must be 18 years old or under. Provide Birthdate below. - OR - any person between the ages of 19 & 25, possessing a current valid student ID from an accredited institution, may also apply for Student Membership. A photocopy of a current valid student ID must be provided with the application and each annual renewal to obtain and maintain this membership
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__ NMRA one year....$24.00
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Total _________
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- Member - All Rights and Benefits without Scale Rails
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__ NMRA one year ...$36.00
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__ MWR Waybill subscription ...$6.00
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- - or -
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__ NMRA two years ...$72.00
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__ 2 year Waybill subscription ...$12.00
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Total _________
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- Member with Subscription - All Rights and Benefits and Scale Rails
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__ NMRA one year ...$48.00
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__ MWR Waybill subscription ...$6.00
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- - or -
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__ NMRA two years ...$96.00
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__ MWR Waybill subscription ...$12.00
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Total _________
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- Family Member - Spouse or Minor Child of above member in good standing. No Scale Rails, no voting rights and cannot be elected to regional or national office. Please provide Family Member's Name and Birthdate below.
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__ NMRA one year ...$ 7.00
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Total _________
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- Sustaining - Mandatory for Group Memberships (Clubs, Associations, Businesses). All benefits and Scale Rails. Nonprofit Educational Association Tax Deduction.
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__ NMRA one year...$96.00
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Total _________
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Name:_______________________________________________ Date:__________
Please Print
Address:____________________________________________________________
City:_____________________ State/Province:________ Zip/Postal Code:________
Telephone (Home): (_____)____________________ Country:_________________
NMRA # (renewals only):____________________ Date of Birth:_______________
Special Interests (include prototype):______________________________________
Scale & Gauge:____________ Occupation (optional):________________________
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