Membership Info
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Your Full Name *
Your Birthday
*This is not a requirement, and we will not share your birth year. This information will be used to post celebrations on Facebook and share amongst members for milestone birthdays.
MM
/
DD
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YYYY
Preferred Method of Membership Payment   *
Verify your contact info / Address *
Please leave your email, phone number and address that you feel comfortable sharing. If you don't feel comfortable, please leave a method of contact so Brenda can email or call to verify your info.
Years in Service
*If you remember
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