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The Gerstner Owners Club
Application for Membership

Your Name:
(As you want it to appear on your Membership card)

Address:

City:

State:
Zip Code:

Country:
Phone:

E-Mail:

Current Occupation:
(or if retired, Former Occupation)

Number of years in Occupation:

My First Gerstner Chest was:
New
Used
Approximate year you acquired your first Gerstner chest:

My Hobbies include:

I use my Gerstner Chest to hold:


Proof of Ownership is required for membership. Indicate which of the following Proof of Ownership you will be sending to Gerstner:
E-mail or Mail a photo of your Gerstner Chest.
E-mail or Mail a copy of Bill of Sale which shows my name, chest style or model number, purchase price and date of transaction.
E-mail or Mail a copy of an Age of Chest Certificate from H. Gerstner & Sons.
I am including my order for a new Gerstner Chest.

I wish to pay the $30 first year dues with:
Credit Card - (by phone at 800-888-5269).
Check or Money Order.
PayPal - (a PayPal payment button will be on the next page).

Questions or Comments:





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