Providence & Worcester Railfan Club & Museum,Inc.
Online Membership Application
3 Davis Street
Webster,Ma 01570
(Please Print)
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New_______ Renewal_______ Date_______

Name_________________________________
Address______________________________
Town________________ State___________ Zipcode_____________
Phone(____)_______________ Referred By_________________
Email Address_____________________________
Railroad Specialty_________________________________
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Type of Membership

Membership year runs Feb 1st thru Jan 31st
Regular Membership--One Person-- $17.00 per year__________

Junior Membership--A person under age 18. Has all rights of a Regular Membership except voting-- $10.00 per year_____________

Family Membership--A card for all members of the family ;only one active member has a vote. Allows member's family to partake in all club activities.-- $20.00 per year_____________

For Family Membership please list all names below.

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I hereby understand that I will be dismissed from the club by a majority vote with no refund of dues if I do anything to cause harm between relations of the club and the Providence & Worcester Railroad. I will follow all rules explained to me on conduct around railroad property and railroad equipment. I also understand that I will be dismissed if caught stealing from any railroad, the club or it's members.

Signature _____________________________________________________
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Do Not Fill Out Below Line

Date Accepted/ Renewed ______________ Accepted By ______________ Denied/Terminated/Reason_____________________________________
Rev 11-17
JLR