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MEMBERSHIP APPLICATION AND RENEWAL FORM:
 
Name __________________________________Tel #: ______________________ 

Address_____________________________________________________________

City, State, Zip ___________________________________________________

Wife's Maiden Name_________________ Email #:________________________

Birthdays (H):______________ (W):________________ Anniv: ___________

Occupation (H):_____________________  (W):__________________________

Ancestral Information:
Husband's Village (s) ______________________________________________

Husband's Surname(s) _______________________________________________

Wife's Village (s) _________________________________________________

Wife's Surname(s) __________________________________________________

Renewal ________  New Member _________  Dues for: __________ year (s)

Date _______________________ 200__
  
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