| ST. Lawrence NYSARC Membership | |
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I would like to join St. Lawrence NYSARC with an annual membership for $5.00. |
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Please sign me up to become a Lifetime Member for $100.00. |
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Name:
_________________________________ Phone: ___________
Address: _________________________________________________ E-Mail: ________________________________ |
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I would like to buy gift memberships
for the following people for $5.00 each.
Additional names and contact information may be listed on the back
of this form. |
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Name:
____________________________ Phone: ________________
Address: _________________________________________________ |
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Name:
____________________________ Phone: ________________
Address: _________________________________________________ |
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I would like to offer a donation to further programs for St. Lawrence NYSARC for___________________ . |
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