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Membership Dues.....................                               $25.00

General Donation .................                                     $________

Donation in Honor of ..........                                      $________ Please send the Name(s) of the honoree(s) along with the address to which the acknowledgement is to be sent as well as your name and address.

Donation in Memory of ..........                                    $________ Please send the Name(s) of the deceased along with the name and address to which the acknowledgement is to be sent as well as your name and address