Rushlight Club Membership Form

Please print neatly and legibly. Please provide complete information, even if this is a renewal.
The information provided will used in the annual updates of the membership directory.
If possible, please provide a legible email address.

Date:________________________________________________________________________

First Name:_________________________Surname:___________________________________

Spouse/Partner First Name:_____________________Surname:___________________________

Mailing address:________________________________________________________________

City____________________State:_______________Zip_____________Country_____________

Telephone:(______)_________________E-mail:_____________________________________

Are you a collector? ______________ a Curator? _____________ a researcher? ______________

Your lighting interests? (6 words or less)?______________________________________________

Membership dues are for the calendar year beginning Jan. 1^st in the following amounts. (US funds)

USA members;
• $40 New members
• $35 Renewing member, before February 1
• $40 Renewing member, after February 1

CANADIAN members
• $45 New members
• $40 Renewing members before February 1
• $45 Renewing members after February 1

OVERSEAS members
• $50 New members
• $45 Renewing members before February 1
• $50 Renewing members after February 1



Please mail the completed application with a check or money order made payable to "The Rushlight Club" to:


The Rushlight Club, c/o Larson Mick, Treasurer
3101 Anderson Pike
Signal Mountain, TN 37377-1421


Corrections of address and email information may be sent to: database_manager@rushlight.org. Please include the word "Rushlight" in the subject line.