Name:

Address:

City: State: Zip:

Country (if other than USA):

I wish to pay by : <choose one> Personal Check Money Order Visa Mastercard Discover Card Number: Expiration:

OPTIONAL INFORMATION

Evening Phone: Day Phone:

E-mail address:

Which of the following railroads are you interested in: N&W . Virginian Rwy . Norfolk Southern

If you model, which scales do you model: N . HO . S . O . G . Other

If you have areas of interest or skill which you would like to volunteer to the Society, please indicate below:

Research . Publishing . Accounting . Photography . Writing . Archives

Membership classes and dues: (check one)

If you wish, you can "lock in" these rates by paying for two years at once. (Amount is twice the one year rate.)

REGULAR ($30.00) Provides all regular N&WHS benefits for one year.

SUSTAINING ($45.00) Includes all regular N&WHS benefits for one year AND provides additional support for the work of the Society. Any amount over $30 is tax-deductible in the USA.

INTERNATIONAL ($45.00) Includes all regular N&WHS benefits for one year and includes the cost of mailing outside the US.

INTERNATIONAL SUSTAINING ($60.00) This option gives our international members the opportunity to provide additional support.

Revised 26-March-2006