CDS Membership Due Form 2010

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MEMBERSHIP DUE FORM - 2010

____ Yes, I/we want to join St. Louis Catholic Deaf Society for $10 per person
--- OR ---
____ Yes, I/we want to join both St. Louis Catholic Deaf Society and International Catholic Deaf
Association, United States Section (ICDA-US) including one-year subscription of The
Deaf Catholic magazines for $20 per person
Name_____________________________
______________ ___NEW

Address_________________________________________ ___RENEW

City____________________ State____ZIP_____________

Phone No: (____) ____-_________ (TTY or Voice or Both)

Email: _________________________________________

VP: ___________________________________________

Please pay to: St. Louis Catholic Deaf Society and mail the form and
check or money order to: Ronald Huddleston, Treasurer
9544 Mackenzie Circle Drive
Affton, MO 63123-5474

MEMBERSHIP DUE FORM - 2010


____ Yes, I/we want to join St. Louis Catholic Deaf Society for $10 per person
--- OR ---
____ Yes, I/we want to join both St. Louis Catholic Deaf Society and International Catholic Deaf
Association, United States Section (ICDA-US) including one-year subscription of The
Deaf Catholic magazines for $20 per person
Name_____________________________
______________ ___NEW

Address_________________________________________ ___RENEW

City____________________ State____ZIP_____________

Phone No: (____) ____-_________ (TTY or Voice or Both)

Email: _________________________________________

VP: ___________________________________________

Please pay to: St. Louis Catholic Deaf Society and mail the form and
check or money order to: Ronald Huddleston, Treasurer
9544 Mackenzie Circle Drive
Affton, MO 63123-5474

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