Travelers' Century Club Membership Application
To apply for TCC membership, fill out this form and check off the destinations you have visited on the list
below. Then mail your application with the appropriate initiation fee and dues payment to:
Travelers' Century Club
8939 S. Sepulveda Blvd., Suite 102
Los Angeles, CA 90045
Tel: (888) 822-0228
E-mail: [email protected]
INSTRUCTIONS: New members must pay the $100 per person initiation fee plus the first yearly dues
payment (membership fees are detailed at the bottom of this page). Your membership will not be
processed without the appropriate fee. You will receive a TCC Membership Card and Membership
Certificate, along with periodic issues of our publication, The Centurian. Please allow 6-8 weeks for
processing of membership. This fillable PDF form may be filled out on your computer and printed for
submission to the TCC, or you may print the blank form and complete your application by hand.
Total number of destinations
NAME: ____________________________________________ visited (from list below): ________
SPOUSE (IF ALSO JOINING): __________________________
ADDRESS: _________________________________________
__________________________________________________
TEL: ______________________________________________
E-MAIL: ___________________________________________
Payment Method:
Check
American Express
Visa
MasterCard
PayPal
(The Travelers' Century Club PayPal ID is [email protected])
Name on credit card: _______________________________________ Payment amount: __________
Card number: ________________________________________ Expiration date: __________________
Zip/postal code on billing address: _______________________ Authorization code: _______________
(Located on front of AmEx Card, back of visa or MC)
Cardholder's signature: _______________________________________________________________
MEMBERSHIP FEES: Membership fees will not be prorated except for November and December.
Please note that higher dues for members requesting mailed Info Files are to cover the cost of printing
and mailing (alternatively members may read Info Files on the TCC Forum Web site).
• Initiation fee: $100 per member, $100 for spouse
• Yearly dues with mailed Info Files:
U.S. residents: $85, spouse $65 (residents of other countries: $95, spouse $65)
• Yearly dues without mailed Info Files:
U.S. residents: $75, spouse $65 (residents of other countries: $85, spouse $65)
PROVISIONAL MEMBERSHIP: If you have 75 or more countries and territories and you cannot yet
qualify as a full member, you are welcome to attend club meetings. At your request, we will put you on a
Provisional Member mailing list to receive The Centurian newsletter. Yearly dues for Provisional
Members are listed below (no initiation fee required).
• Provisional Membership with mailed Info Files: U.S. residents: $85 (residents of other
countries: $95)
• Provisional Membership without mailed Info Files: U.S. residents: $75 (residents of other
countries: $85)
Name: ________________________________
LIST OF TCC COUNTRIES AND TERRITORIES:
PACIFIC OCEAN (39)
! Australia
! Bismark Archipelago (New Ireland, New Britain,
Bougainville, Admiralty Islands)
! Chatham Islands
! Cook Islands (Rarotonga, Aitutaki, Penrhyn)
! Easter Island
! Fiji Islands
! French Polynesia (Tahiti, Tuamotu, Austral,
Gambier)
! Galapagos Islands
! Guam
! Hawaiian Islands
! Juan Fernandez Islands (Robinson Crusoe Is.)
! Kiribati (Gilberts, Tarawa, Ocean Island)
! Line/Phoenix Islands (Palmyra, Fanning,
Christmas, Canton, Enderbury, Howland)
! Lord Howe Island
! Marquesas Islands
! Marshall Islands, Rep. of (Majuro, Kwajalein,
Eniwetok)
! Micronesia, Fed. States of (Pohnpei, Kosrae,
Chuuk,Yap, Caroline Islands)
! Midway Island
! Nauru
! New Caledonia & Deps. (Noumea,
Loyalty Islands)
! New Zealand
! Niue
! Norfolk Island
! Northern Marianas (Saipan, Tinian)
! Ogasawara (Bonin, Volcano Island, Iwo Jima)
! Palau, Republic of
! Papua New Guinea
! Pitcairn Island
! Ryukyu Islands (Okinawa)
! Samoa, American (Pago Pago)
! Samoa, Western (Apia)
! Solomon Islands (Guadalcanal, New
Georgia, Tulagi)
! Tasmania
! Tokelau Islands (Fakaofu, Atafu, Union)
! Tonga (Nukualofa)
! Tuvalu (Ellice Island, Funafuti, Vaitapu)
! Vanuatu (New Hebrides Islands)
! Wake Island
! Wallis & Futuna Islands
NORTH AMERICA (6)
! Alaska
! Canada
! Mexico
! Prince Edward Island
! St. Pierre & Miquelon
! United States (continental)
CENTRAL AMERICA (7)
!
!
!
!
Belize (British Honduras)
Costa Rica
El Salvador
Guatemala
! Honduras
! Nicaragua
! Panama
SOUTH AMERICA (14)
!
!
!
!
!
!
!
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
French Guiana
!
!
!
!
!
!
!
Guyana (British Guiana)
Nueva Esparta (Margarita Island)
Paraguay
Peru
Surinam (Netherlands Guiana)
Uruguay
Venezuela
CARIBBEAN (30)
!
!
!
!
!
!
!
Anguilla
Antigua & Deps. (Barbuda, Redonda)
Aruba
Bahamas
Barbados
Bonaire
Cayman Islands
!
!
!
!
!
!
Martinique
Montserrat
Puerto Rico
St. Barts
San Andres & Providencia
St. Kitts & Nevis
Travelers' Century Club Membership Application ! Page 2
Name: ________________________________
CARIBBEAN (CONT.)
!
!
!
!
!
!
!
!
!
!
Cuba
Curacao
Dominica
Dominican Republic
Grenada & Deps. (Carriacou, Grenadines)
Guadeloupe & Deps. (Marie Galante)
Haiti
Jamaica
Leeward Islands, French (St. Martin)
Leeward Islands, Netherlands (Saba,
St. Eustatius)
! St. Lucia
! St. Maarten (formerly Netherlands Antilles)
! St. Vincent & Deps. (Bequia, Canouan,
Grenadines)
! Trinidad & Tobago
! Turks & Caicos Islands
! Virgin Islands, U.S. (St. Croix, St. John,
St. Thomas)
! Virgin Islands, British (Tortola, etc.)
ATLANTIC OCEAN (13)
!
!
!
!
!
!
Ascension
Azores Islands
Bermuda
Canary Islands
Cape Verde Islands
Falkland Islands
!
!
!
!
!
!
!
Fernando do Noronha
Faroe Islands
Greenland (Kalaallit Nunaat)
Iceland
Madeira
St. Helena
Tristan da Cunha
EUROPE & THE MEDITERRANEAN (67)
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
Aland Islands (Mariehamn)
Albania
Andorra
Austria
Balearic Islands (Mallorca, Minorca)
Belarus
Belgium
Bosnia & Herzegovina
Bulgaria
Corsica
Crete
Croatia
Cyprus, Republic
Cyprus, Turkish Fed. State
Czech Republic
Denmark
Dodecanese Is. (Rhodes)
England
Estonia
Finland
France
Germany
Gibraltar
Greece
Guernsey & Deps (Alderney, Herm, Sark,
Channel Islands)
Hungary
Ionian Islands (Corfu, etc.)
Ireland (Eire)
Ireland, Northern (Ulster)
Isle of Man
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
Kosovo
Lampedusa
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
Russia
San Marino
Sardinia
Scotland
Serbia
Sicily
Slovakia
Slovenia
Spain
Spitsbergen (Svalbard, Bear Island)
Srpska
Sweden
Switzerland
Trans Dniester
Turkey in Europe (Istanbul)
Travelers' Century Club Membership Application ! Page 3
Name: ________________________________
EUROPE & THE MEDITERRANEAN (CONT.)
! Italy
! Jersey (Channel Islands)
! Kaliningrad
! Ukraine
! Vatican City
! Wales
ANTARCTICA (7)
! Argentine (Palmer Peninsula)
! Australian Antarctic Territory South Pole
(Mawson, Davis, Macquarie, Heard)
! Chilean (Palmer Peninsula)
! British Antarctica (Graham Land, South
Shetland, South Orkney)
! French Southern & Antarctic Territory
(Kerguelen, Crozet, Amsterdam, St. Paul)
! Norwegian (Queen Maud Land, Bouvet)
! New Zealand (Ross Dependency)
AFRICA (55)
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
Algeria
Angola (Port. West Africa)
Benin (Dahomey)
Botswana (Bechuanaland)
Burkina Faso (Upper Volta)
Burundi (Urundi)
Cabinda
Cameroon
Central African Republic
Chad
Congo (Brazzaville)
Congo (Kinshasa-Zaire)
Djibouti (French Somaliland, Affars & Issas)
Egypt in Africa
Equatorial Guinea (Bioko, Fernando Poo)
Equatorial Guinea (Rio Muni)
Eritrea
Ethiopia
Gabon
Gambia
Ghana (Gold Coast, British Togoland)
Guinea (French Guinea)
Guinea-Bissau (Port. Guinea)
Ivory Coast
Kenya
Lesotho (Basutoland)
Liberia
Libya
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
Malawi (Nyasaland)
Mali (French Soudan)
Mauritania
Morocco
Morocco, Spanish (Ceuta, Melilla)
Mozambique (Port. East Africa)
Namibia
Niger
Nigeria
Rwanda (Ruanda)
Sao Tome & Principe
Senegal
Sierra Leone
Somalia (Italian Somaliland)
Somaliland (British)
South Africa
South Sudan
Sudan
Swaziland
Tanzania (Tanganyika)
Togo
Tunisia
Uganda
Western Sahara (Spanish Sahara)
Zambia (No. Rhodesia)
Zanzibar
Zimbabwe (So. Rhodesia)
MIDDLE EAST (21)
!
!
!
!
!
!
!
!
!
!
!
Abu Dhabi
Ajman
Bahrain
Dubai
Egypt in Asia (Sinai Peninsula)
Fujeirah
Iran
Iraq
Israel
Jordan
Kuwait
!
!
!
!
!
!
!
!
!
!
Lebanon
Oman
Palestine
Qatar
Ras Al Khaimah
Saudi Arabia
Sharjah
Syria
Umm Al Qaiwain
Yemen
Travelers' Century Club Membership Application ! Page 4
Name: ________________________________
INDIAN OCEAN (15)
! Andaman-Nicobar Islands
! British Indian Ocean Territory
(Chagos Archipelago, Diego Garcia)
! Christmas Island
! Cocos Islands (Keeling)
! Comoro Islands
(Anjouan, Moheli, Grand Comoro)
! Lakshadweep
! Malagasy Republic (Madagascar)
! Maldive Islands
! Mauritius & Dependencies
(Agalega, St. Brandon)
! Mayotte (Dzaoudzi)
! Reunion & Dependencies
(Tromelin, Glorioso)
! Rodrigues Island
! Seychelles
! Socotra
! Zil Elwannyen Sesel
(Aldabra, Farquhar, Amirante Islands)
ASIA (51)
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
Abkhazia
Afghanistan
Armenia (Yerevan)
Azerbaijan (Baku)
Bangladesh
Bhutan
Brunei
Cambodia
China, People's Republic
China, Republic of Taiwan
Georgia
Hainan Island
Hong Kong
India
Indonesia (Java)
Japan
Jeju Island (South Korea)
Kalimantan (Indonesian Borneo)
Kashmir
Kazakhstan
Kyrgyzstan
Korea, North
Korea, South
Laos
Lesser Sunda Islands (Bali, Indonesia)
Macau
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
!
Malaysia
Moluka (Moluccas, Indonesia)
Mongolia, Republic
Myanmar (Burma)
Nakhchivan
Nepal
Pakistan
Papua (Irian Jaya)
Philippines
Sabah (North Borneo)
Sarawak
Siberia (Russia in Asia)
Sikkim
Singapore
Sri Lanka (Ceylon)
Sulawesi (Celebes, Indonesia)
Sumatra (Indonesia)
Tajikistan
Thailand
Tibet
Timor Leste
Turkey in Asia (Anatolia, Ankara, Izmir)
Turkmenistan
Uzbekistan
Vietnam
THIS LIST IS RECOGNIZED BY THE WORLD AS THE STANDARD OF
COUNTRIES AND TERRITORIES THAT ARE POLITICALLY,
ETHNOLOGICALLY OR GEOGRAPHICALLY DIFFERENT.
Version: June 2016
Copyright © 2016 The Travelers' Century Club
Travelers' Century Club Membership Application ! Page 5