Registration
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Name______________________________________________________________________________ Nickname______________________________ Class Year_______________________ Address___________________________________________________________________________ City_______________________________________ State & Zip Code_______________________ Home phone_____________________________ Email address:____________________________ Occupation_________________________________________________________________________ Name of Business___________________________________________________________________ Business Address___________________________________________________________________ Business Phone and Fax:____________________________________________________________ Business Email Address:_____________________________________________________________ Spouse's Name:____________________________________________________________________ Children's Names & Ages:____________________________________________________________ _________________________________________________________________________________ Dues for the 2002-2003 year are $15.00. I have enclosed $________ cash______ check______
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