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NHRHTA MEMBERSHIP APPLICATION FORM

Updated July 27th, 2010


Please print out a copy of this page, complete the questions and send this form along with a check payable to "Treasurer, NHRHTA", to:

Richard Pedersen, NHRHTA Membership Chairman
59 Waterfall Court
Bloomingdale, NJ 07403
E-mail: nynhh@msn.com


Please print the following information:

Name (Last, First):___________________________________________________________________________________

Mailing Address:____________________________________________________________________________________

City:___________________________________________ State:____________________ Zip:______________________

Country:_________________________________ Telephone:____________________________ Date:________________

E-mail Address:_____________________________________________________________________________________

Are you a former NHRHTA member? [ ] yes. [ ] no.

Membership category: United States resident -- [ ] Regular ($35.00). [ ] Sustaining ($50.00).

Membership category: Canadian resident -- [ ] Regular (US$46.00). [ ] Sustaining (US$61.00).

Membership category: Other Foreign resident -- [ ] Regular (US$69.00). [ ] Sustaining (US$79.00).

By becoming a Sustaining Member, your donation helps the NHRHTA expand its production of magazines, books, videos and other New Haven Railroad related material. Please consider a Sustaining Membership. Thank you.

Canadian and foreign subscribers - please contact Rich Pedersen via mail or E-mail BEFORE sending any funds.  He has PAYMENT ALTERNATIVES that may save you currency conversion fees.

Please include a check for your membership category amount payable to "Treasurer, NHRHTA" and mail this completed form to:

Richard Pedersen, NHRHTA Membership Chairman
59 Waterfall Court
Bloomingdale, NJ 07403
E-mail: nynhh@msn.com