Museum of Gaming History
   An Educational Project of The Casino Collectibles Association, Inc.
   An IRS approved 501 (c) (3) Tax Exempt Not-For-Profit Organization 		ChipGuide
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Membership Application
The Casino Chip and Gaming Token Collectors Club, Inc.

Name:
Address:
City:
State: Zip: 
Phone: E-Mail:
Collecting Interests: Chips       Tokens       U.S.       Foreign       Other
Please publish my: Name and Address       Phone       in the club membership directory
Please publish my name, E-Mail address and collecting interests on the club web page: Yes       No
Do not publish my information in either
I have enclosed my annual dues for:One Year $40 3rd Class Delivery
Associate $7 Member in same household as a regular member
Foreign $55 Postal money order or US funds
For FIRST CLASS magazine delivery add $16 (U.S. Only)
Foreign mailings are First Class, regular mailings are Third Class unless First Class is added.
Print this completed application and mail with your check made out to CC&GTCC to:
CC&GTCC Membership Officer
Jay Sands
3381 Carsebridge Drive
Henderson, NV 89044
Sponsored by: The ChipGuide
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