
Membership Application for the National Toothpick Holder Collectors Society
Name: ___________________________________________
Phone number: _________________________________
Address:
___________________________________________
___________________________________________
___________________________________________
Business name (if dealer):
___________________________________________
E-mail address:
_________________________________________
Do you want your name in the directory? Yes___ No___.
How did you learn of NTHCS? ________________________________
Make your check payable to NTHCS and mail it along with this application to:
NTHCS
PO Box 852
Archer City, TX 76351