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Membership Type: (Circle one) Full / Contributing
Desired username: ______
Phone number: ______
Email address: ______
Nominated for membership by: ______
__ I have read and agreed to abide by the bylaws.
__ I have signed the liability waiver.
Applicant Signature: ______ Date: ______
__ Applicant has been approved by present members.
Board Member Signature: ______ Date: ______