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Membership Application
Levels of membership and annual dues in the Club are (1)$100 for a
Bull Elephant Sponsor, (2)$50 for a Sponsor, and (3)$25 for regular
membership. Please mark the membership level you choose.
Make your check payable to the Republican Club of Lakeland and mail
to:
Today’s Date_______________________________________________
Nickname _________________________________________________
Address ___________________________________________________
City ______________________________________________________
State____________________ Zip_______________________________
Phone-work ________________________________________________
Phone-home _______________________________________________
E-mail ____________________________________________________