2012 MEMBERSHIP APPLICATION
NAME/S ______________________________________________
STREET ADDRESS _____________________________________
CITY ____________________________
STATE _____________ ZIP CODE ______________
PHONE __________________
E-MAIL ____________________________
_______ Please check here if you do not want the above
information in the KVAS directory.
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Membership classes: Student $6, Individual $8, Family $10.
Cut and paste, print and fill out the above and send with dues to:
Ken Young, Treasurer KVAS,
637 White Oak Dr, Chester IL 62233
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