Membership Application
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Annual membership to the local chapter is $7.00 per person or
couple.
NAMES:
___________________________________________________________ ___________________________________________________________ ADDRESS: ___________________________________________________________ CITY: ______________________ STATE:____ ZIP_______________ PHONE: Home: _________________________________ Business: ______________________________ Fax: ___________________________________ EMAIL: ____________________________________________________ AMOUNT PAID ___________ Cash ____ Check #___________ New Members Please Name Sponsor:____________________________________________________ MAIL TO: Jerome
Substanley 1025 Arcaro Drive
Gahanna, OH
43230
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