MTL Membership Form

To become either a member or newsletter subscriber of The Milwaukee Time Lords print this form out, fill in all information, and send it in with a check to the snail-mail address given at the bottom of this page.

___ Individual Membership* $14.00
___ Family Membership* $14.00 for 1st person + $1 per additional member
___ Non-membership Newsletter subsciption $12.50
___ Foreign Newsletter Subscription $20.50 (U.S. funds)

Name:_____________________________________________________________________

Address:__________________________________________________________________

City, State, Zip:____________________________________________________________

Country: ______________________

E-mail address: ______________________________________

Today's Date:________________ Phone: __________________________

________________________________________________________________________________
* - Memberships include a membership card which provides discounts at the following fine Milwaukee area stores. Note that restrictions may apply.
Belich's Nostalagia World - 8228 W Lincoln Avenue
The Turning Page - 2452 N Murray Avenue
F-5 Comics - 6233 W Greenfield Avenue
 
The Milwaukee Time Lords
c/o Lloyd Brown
2446 N 69th Street
Wauwatosa, WI 53213-1314
The Milwaukee Time Lords