NAME Shop Membership Application

Print this form and mail with payment to:

National Association of Miniature Enthusiasts
P.O. Box 69
Carmel, IN 46082
(317) 571-8094
(317) 571-8105 FAX

Benefits of Membership

Shop Name_______________________________________________________________

Contact Name_____________________________________________________________

Address_________________________________________________________________

City/State/Zip+4___________________________________________________________

Telephone________________________________________________________________

Shop Hours_______________________________________________________________

E-mail___________________________________________________________________

Web URL________________________________________________________________

E-mail NAME web site ad copy & logo (no larger than 300 x 60 .GIF or .JPG) to
NAME Webmaster: bsteinke@bjminis.com

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