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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:
Photo of me and my Gerstner Chest.
Photocopy of Bill of Sale which shows my name, chest style or model number, purchase price and date of transaction.
Photocopy 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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