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2010 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. Print, cut, 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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