MEMBERSHIP APPLICATION RENEWAL FORM by llf87114

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									   MEMBERSHIP APPLICATION & RENEWAL FORM

IN ORDER THAT WE MAY PROPERLY GIVE YOU
CREDIT FOR YOUR DUES PAYMENT, PLEASE FULLY
COMPLETE THIS FORM AND MAIL WITH YOUR CHECK.

MEMBERSHIP APPLICATION/RENEWAL ---
Tax-deductible Annual Membership Fee: O N L Y $15.00
YEARLY PER MEMBER

YOUR GRADUATION OR CLASS YEAR: 19/20________
NEW MEMBER ___ RENEWAL ___

NAME: ________________________________________;
MAIDEN NAME: _______________________

BIRTH DATE: ___________; ADDRESS:
________________________________________________
__

CITY __________________________ STATE ______ ZIP
_________ PHO: (_____) _______________
E-MAIL ADD:
____________________________________________

TO: Gladewater Former Students’ Assoc.
    PO Box 1425
   Gladewater, TX 75647

								
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