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Clive Cussler Collector's Society
MEMBERSHIP FORM
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If you are interested in joining and don't wish to use PayPal, simply print this page and send your check or money order to:

Clive Cussler Collector's Society
1190 E. HWY 372 #17 PMB #1
Pahrump, Nevada 89048

Unfortunately, due to high bank fees, we do not accept checks in foreign currencies.

Name ________________________    
Address 1 ________________________    
Address 2 ________________________    
City ________________________ State ______
Province ________________________ Postal Code _______________
Country ________________________    
Phone ________________________ E-mail ________________________
Do you wish your contact information to be included on the Our Membership password protected page on our Web site? (yes or no) ______

   cusslersociety@xpressdata.net