Members Order Form

Keeping Traditional

Country Music

Alive & Well

The International Traditional Country Music Fan Club

Phone: 423-542-5543

101 Cripple Creek Road

(or) P.O Box 161

Watauga, Tn. 37694

For Oversea & Canada -yearly

Copies of the Fanzine this issue

Reg. Club Membership - yearly

Sign-Up Form for Members

5.00

$12.00

$10.00

Subtotal:

Time

Cost: $3.00

00:00

Cash

Money Order

Check

Method of Payment

Name:

Address:

Phone:

E-mail:

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City:

Zip/Post. code:

Country:

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If you don't want to use this form...Fill it out and Screen Print the form and mail the form with your check, Cash or Money Order to:

Itcm Fan Club At:

101 Cripple Creek Road, Watauga , Tennessee 37694 ( or ) use

P.O. Box 161

Feel Free to call Junior O'Quinn at: ( 423 ) 542-5543

Fill out and Screen Print this form to First , then click the submit button below to let me know you plan on becoming a member

Hank Collector:

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