| $20.00 Annual Dues |
|---|
|
|
Please 
PRINT and FILL OUT the application below,then mail it to: THE OFFICIAL MEL CARTER INTERNATIONAL FAN CLUB P.O. Box 48426 Los Angeles, CA 90048 Enclose a Check or Money Order for $20.00 US payable to MEL CARTER - CSP mc Please allow 3-4 weeks for delivery. |
| Your Name: | _____________________________ |
| Street: | _____________________________ |
| Apt, Suite: | _____________________________ |
| City: | _____________________________ |
| State: | ______ ZIP:______________________ |
| Country: | _____________________________ |
| Age: | _____________ (optional) |
