Akro Agate Registration Form

Print this form and fill it out.

Then send payment (Personal Check or Money Order) to:

Roger Hardy
10 Bailey Street
Clarksburg, WV 26301-2524.

Questions or Comments?
Email: Roger & Claudia <== Click or Email ==> rhardy0424@yahoo.com

or...

Call us at:
304-624-7600 EST.

Annual membership is $25.00 (Foreign members $35.00)
Includes a quarterly newsletter - The Clarksburg Crow.

Memberships run January to January

AKRO AGATE COLLECTOR'S CLUB REGISTRATION FORM

Join Today!

Send this completed form in ASAP to receive your Official Akro Agate Collector's Club Membership Card & Number.

Name(s): _______________________________________________________

_______________________________________________________

Please print one or two names per address.

Mailing Address: _______________________________________________

City/State/9-digit zip code: ___________________________________

Area Code/Number/Time Zone: ____________________________________

Internet/Email Address: ________________________________________

Please indicate below if you are an Akro: Please check all that apply.

_____ Collector(s)

_____ Dealer

_____ Both Collector(s) & Dealer

_____ I have been collecting Akro for __ years?

And which line(s) you specialize in:

_____ All Lines

_____ Marbles

_____ General Line

_____ Child's Tea Sets