Membership Application or Meeting Invitation Request?

Name:

Street Address 1:

Street Address 2:

City, State, Zip+4 Code:

Home phone w/Area Code:

Work phone w/Area Code:

Mobile phone w/Area Code:

Email address:

NMRA Membership No:      MER Membership No:

Date of Birth:      Marital Status:

Occupation:      Working?      Retired?

How long have you been involved in model railroading?

What gauges/scales do you model?

Describe any layouts you now own, if any:

Skill level in modeling?     Novice      Intermediate      Advanced

Favorite railroads?

Railroads modeled?

List any special skills you have for model railroading (example: electrical, electronics, airbrushing techniques, drafting, woodworking, decaling, scenery, etc.)

List model railroad clubs or organizations in which you are or have been a member:

Any other information about you that you feel the Carolina Piedmont Division 13 should know about you as a modeler and a person:

My check or money order for $ is enclosed.

Mail completed applications (with payment made out to Carolina Piedmont Division") to:

Carolina Piedmont Division 13, NMRA MER
3118 Seth Drive
Sanford, NC 27330

Payment must accompany registration form. Please DO NOT staple check or money order to your registration form.

OFFICE USE ONLY:

Received:_____________ Check #:__________ Amount:____________ Registration No.: ___________