New Member Form

Date: __________                  Member # :________

Last Name:___________________________

First Name:___________________________

Address:____________________________

Address:_____________________________

Town:_______________________________

 State, ZIP ___________________________

Driver Lic. state/:_____________

Mail:______________________

Cell _______________________

 

I agree with the current consignment contract posted on www.mens-exchange.com.

Men’s Exchange Consignment Shop

2 N. 5 Points Rd West Chester, PA 19380