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click the submit button at bottom of this form.
Thank you for your support and donation !
This club is for individuals only ... (No Organizations)
(* information will be kept private and confidential)
NAME FOR EACH MEMBERSHIP (First & Last Name)
*CITY
*STATE
*ZIP CODE
*EMAIL (If you have no email address type "NONE")
*YOUR PREFERRED SHAG CLUB OR CLUBS
MEMBERSHIP TYPE
QUANTITY
Amount
Subtotal
Regular Membership
TOTAL REMITTANCE
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To: Shagtour
PO Box 399
Salisbury, NC 28145