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Home > Family & Friends > Membership Form

Membership Form

Please complete one enrollment form per person.

Within 6-8 weeks after providing credit card information, new members will receive a complete membership kit, including a free welcome gift.

Once completed, simply mail or fax this form to:

M.I. Hummel Club
3705 Quakerbridge Road
Suite 105
Mercerville, NJ 08619

[Fax] 1-800 HUMMEL4

Visa, MasterCard, American Express and Discover (US only) are gladly accepted.

Please Check one of the Following Two Choices

[ ] YES! I want to join the M.I. Hummel Club® and enjoy all the benefits you've reserved for me,
including a free gift valued at an SRP of $125.

Auto-Renew Program for credit/debit card customers only:
[ ] YES, I would like to enjoy the convenience of automatic renewal so I can be sure my membership benefits will continue uninterrupted. Please automatically re-enroll me in the Club each year and charge my credit/debit card the then-current renewal rate less 10%, unless you hear otherwise from me. I will also enjoy all the benefits you've reserved for me, including a FREE gift valued at an SRP of $125!

_____________________________________
(name of new member)

_____________________________________
(street)

_____________________________________
(city)

_____________________________________
(state/province)

_____________________________________
(zip/postal code)

_____________________________________
(country)

One year's membership fee of $60* will be charged to (check one):

[   ] VISA
[   ] MASTERCARD
[   ] DISCOVER (US only)
[   ] AMERICAN EXPRESS

CREDIT CARD NUMBER:_______________________

EXP _____/_____/_____

CARDHOLDER'S NAME:____________________________________________

(Please print)


_____________________________________
(cardholder address if different from above)

_____________________________________
(city)

_____________________________________
(state/province)

_____________________________________
(zip/postal code)

_____________________________________
(email address)

Gender:   [   ] Male       [   ] Female

CARDHOLDER'S SIGNATURE:_____________________________________

(Form #AP32IN)

*U.S. price is $60. For Canadian purchases use U.S. price. Credit Card company will establish and apply the exchange rate. Please allow approximately 8 weeks from receipt at M.I. Hummel for delivery of Renewal Member Kit.

, Hummel® and M.I. Hummel Club®, in signature and/or block forms, are registered trademarks of Manufaktur Rödental GmbH, Germany.
M.I. Hummel figurines, plates and bells are copyrighted products. All products of Manufaktur Rödental GmbH, Germany, are design-patented and copyright protected. All trademarks are registered. © M.I. Hummel 2013. © Goebel 2013. © Disney 2013.