Membership Application Form

First Name (Required)

Last Name (Required)

Email (Required)

Retype Email (Required)

Tel (Required)

Street (Required)

City (Required)

Province (Required)

Postal Code (Required)

NAWCC Member Number

Main Interest (Hold down CTRL to select multiple options):
—Please choose an option—Clock CollectionWatch CollectionClock RepairWatch RepairOtherNone

Secondary Interest (Hold down CTRL to select multiple options):
Clock CollectionWatch CollectionClock RepairWatch RepairOther

Comments (optional)

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