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Tri City Jim Beam Bottle Club Membership Application

TRI-CITY JIM BEAM BOTTLE CLUB
MEMBERSHIP APPLICATION

Please fill out ALL information,  Print out this page and send to Membership Chairman with your check.

        NAME

   SPOUSE  PHONE

ADDRESS 

          CITY  STATE  ZIP

       EMAIL  ANNIVERSARY 

BIRTHDAY      SPOUSE BIRTHDAY 

I/WE COLLECT: HOW LONG?

RECOMMENDED BY:

Couple - International Affliated Membership                           $21.00

Single - International Affliated Membership                             $13.00

Tri-City Jim Beam Club   (Single or Couple)                              $ 5.00

AMOUNT ENCLOSED $___________________   DATE:_____________________

MAIL TO :

TRI-CITY JIM BEAM CLUB
9319 NAVAJO PLACE
SUN LAKES, AZ 85248-7022


Membership runs from January 1st to December 31st.  Dues paid after November 1st will apply for the full following year.  International members joining after June 30th, need to only to pay one-half yearly rate.

ANY QUESTIONS PLEASE FEEL FREE TO EMAIL US

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