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I/We support the efforts of the Council and wish to express this through membership!
Name _____________________________________ Phone _________________
Organization/Company _______________________________________________
Address __________________________________________________________
City __________________ State ______________ Zip Code ________________
Type of membership: __Individual $15. __Non-Profit/Civic $35. __Small Business $50.
__Corporate $100. _Benefactor _$50. _$100. _$250. _$500. _Other ____________
I wish to make a donation of $_______ Please use funds for ____________________
Donations are Tax Deductable To The Extent Of The Law
Make checks payable to ADAC, PO Box 583, 224A Main St, Goshen, NY 10924
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