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Membership Application
Name:
_________________________________
Address:
_________________________________
_________________________________
City:
_________________________________
Postal Code:
_________________________________
Telephone:
_________________________________
e-mail: (Optional)
_________________________________
Membership Info
(check one)
Regular member(10.00)-------------------O
Student/Senior(5.00)-----------------------O
Family membership(25.00)--------------O
Lifetime member(100.00)-----------------O
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