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Rockdale-Newton Section
MEMBERSHIP/RENEWAL APPLICATION
DATE:
NAME:
Address
Email
Phone
BIRTHDAY: MM/DD
NCNW ffiliate Organization(s):
Type of Application
*
Required
New Membership
Renewal of Membership
Life
Legacy Life
Membership Dues Paid:
*
Required
National Dues Paid $75.00
Local Dues Paid $90.00
Total Dues Paid $165.00
Life $1,000
Legacy Life $1500.00
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