Testing New Membership Entry - International Coleman Collectors Club

Name *

First

Last

Additional Name

First

Last

Only for couple membership.

Address *

IMPORTANT: Please enter your FULL postal address, including ZIP/Postcode and Country.

Phone Number *

Email *

Email

Confirm Email

Current ICCC membership status *

I am renewing my membership
I am applying for new membership (i.e. never been a member before)
I am renewing a lapsed membership (e.g. older than 1 year)

Membership Number

For renewals. Do not panic if you have forgotten it, we can probably find your number.

Personal contact information sharing *

I agree to share my address
I agree to share my phone number
I agree to share my email address
I do not want to appear on the list at all (choosing this option will override all other selections)

i.e. name, address, phone, email in the ‘Members List’ in the secure ‘ICCC Members Area’ on the website. Please select ALL the items you wish to share with other ICCC members.

Membership Level (Price US$) *

Payment Method *

I will use PayPal
I am going to mail a check

GDPR Agreement *

I consent to having this website store my submitted information so they can process my inquiry.