W. David Perkins, Treasurer
P.O. Box 3039, Centennial, CO 80161-3039
Office Use Only

JRCS # ___________
Type or Print
(Last Name)

(First Name)

(Middle Initial)
(Street Address)
Date of Birth
(Month  Day  Year)

(Apt / Suite / Other)




The purpose of the John Reich Collectors Society (JRCS) is to encourage the study of numismatics, particularly United States silver and gold coins minted before the introduction of the Seated Liberty design, and to provide technical and educational information concerning such coins. A member’s name and address will not be included in any membership directory issued by JRCS or be disclosed to others without prior consent of such member.

Check the appropriate space below:
   Collector   Collector-Dealer   Dealer (Firm Name)

Indicate your area(s) of interest in Early United States Coins:
a. Flowing Hair Bust Half Dimes
b. Draped Bust Half Dimes
c. Capped Bust Half Dimes
d. Draped Bust Small Eagle Dimes
e. Draped Bust Heraldic Eagle Dimes
f. Capped Bust Dimes
g. Draped Bust Quarter Dollars
h. Capped Bust Quarter Dollars
i. Flowing Hair Bust Half Dollars
j. Draped Bust Half Dollars
k. Capped Bust Half Dollars
l. Flowing Hair Bust Dollars
m. Draped Bust Dollars
n. Gold Issues
Guarantee (if Applicant is under 21 years):
I guarantee payment by the Applicant of his / her debts or other obligations to JRCS or any of its members. I am 21 years or older.

(Signature of Guarantor)
 Relation to Applicant _____________________  
Applicant’s Agreement:
I hereby apply for membership, and agree to uphold the By-Laws of JRCS. As required by the By-Laws of JRCS, I agree to pay promptly all my debts or other obligations to JRCS or any of its members. I enclose a check or money order for $25.00 payable to John Reich Collectors Society for my annual membership contribution, or $625.00 for a life membership in the Society.

  (Date)          (Signature of Applicant)

If applying for reinstatement, please give your former JRCSmember # 

John Reich Collectors Society (Employer Identification No. 34-1427467) is exempt from Federal income tax under Section 501(c)(3) of the Internal Revenue Code. As such, gifts and contributions made to John Reich Collectors Society may be deducted as provided in the Internal Revenue Code.

Back issues of the John Reich Journal are available to members for $9.00 each postpaid.
Visit for additional information. See this page as PDF.