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Name: |
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Mailing Address: |
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Phone: |
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E-Mail (to receive newsletters ): |
_____________________________________________________ |
District: |
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Membership Type: |
____ New Membership ____Renewal |
Other Memberships: |
Member WSRA # __________ Member IRA # __________ |
Include a check payable to: |
| Ashland Bayfield Literacy Council * council prices * council prices |
Please print, fill out and send this form to:
Someone
Some Address
Some Town, WI ZIP