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Name____________________________________
Address__________________________________
City, State, Zip____________________________
Phone #(_____)__________________
E-Mail_________________________
New $20.00 [ ] Renewal (previous member) $20.00 [ ]
if renewal , your membership NO#_____________
Date of application_____/______/______
Local #________
Are you a Registered Voter_____- U.S. District Congressional Dist. ______
- State Senate Dist.______
- State Representative Dist.______
Print and send completed form, along with a check or
money order for $20.00 to:
F.O.R.R., Inc.
1424 Estate Dr.
Bates City, MO 64011 |
