MARLIN FIREARMS COLLECTORS ASSOCIATION, LTD.

                                APPLICATION For MEMBERSHIP



Name________________________________________________________Date______________20______

Mail Address__________________________________________________________________________

City_________________________________________________State________________Zip_________

Street Address______________________________________________Phone_____________________

Place of Employment___________________________________________________________________

Address_____________________________________________Department________________________

Collector  of:________________________________________________________________________

______________________________________________________________________________________

Federal Firearms License   Yes____    No____   

Local or State Dealers License   Yes_____  No______

If Dealer or Gunsmith, Give Details__________________________________________________

_____________________________________________________________________________________

Other Organizations That I am a Member of:___________________________________________

_____________________________________________________________________________________


I certify that I am not presently under indictment for, nor have I ever been 
convicted of, any felony involving a crime of violence or violation of any State or 
Federal firearms law.


			           __________________________________________________
			             Signature of Applicant
									

Mail to:
MFA
P.O. Box  4352
Springfield, IL 62708

Initiation Fee.....................................................$10.00
Annual Dues
United States...................................................... 40.00
Canada    (Must be U.S. Funds drawn on U.S. Bank).................. 45.00
Overseas (Must be U.S. Funds drawn on U.S. Bank)................... 50.00
(Initiation fee and first year dues required with application for membership)