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HRPNA Membership Form
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Date
*
MM
/
DD
/
YYYY
Last Name
*
Your answer
First Name
*
Your answer
Number, Street, City, Zip
*
Your answer
Home phone
Your answer
Cell phone
Your answer
Email address
Your answer
Preferred method of contact
*
Call
Text
Email
Required
I acknowledge that dues are to be paid annually and can be paid via check, money order, cash, or cash app. Please select your membership level.
*
Regular Membership - $25 yearly per household plus an additional $10 for each voting member in the household
Historic Overlay Membership – Same as Regular Membership
Associate Membership: $25 per membership. There are no voting privileges.
Business Membership - $50 yearly per business. Businesses include churches, schools, and community and city entities. There are no voting privileges.
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