THE NEW MAZDA MYSTIC RING           

                                          Membership Application:

                                                                  

There are a few memberships open at this time due to a few of our members moving out of state..

If you would like to become a member of The New Mazda Mystic Ring, Please email or call Bob Coluzzi at ......630.377.8211 or email dekram1@ameritech.net

 

New members must be active in the club, either by holding office or performing at some of the meetings.......

    The New Mazda Mystic Ring

 

Name:______________________________________________________________

Professional Name (if any)____________________________________________

Address:____________________________________________________________

City:________________________State:_____ Zip:________________________

Phone:____________________    Email:_________________________________

Web Site:______________________   Occupation:________________________

Type of Magic performed:____________________________________________

 

I am, at present, connected with Magic as a (n):

Professional ______   Part Time Professional______   Amateur ____________

Collector _______  of  Magic Books________ Magic Apparatus_____________

I am a member of the following Magic Societies ________________________

 

I heard of the Mazda Mystic Ring through_______________________________

____________________________________________________________________

x_________________________________________________                                                                                                                                                       

         Applicant's signature to be signed at meeting.

Copy,  then Press Click Here button, paste  in email, fill out application and send.

                 

                                           

                                                          

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