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Membership Renewal Form

 

Name(s): _________________________________________________________

 

Company: _________________________________________________________

 

Address: __________________________________________________________

 

Home Phone: _______________________________________________________

 

Work Phone: _______________________________________________________

 

Dues: _____ Resident $15            ______ Business $25             ______ Senior Citizen $2          ______

         _____ New Member           ______ Renewal

 

Print this form and mail it to: CSNA, PO Box 73784, Washington, DC 20009

Please make checks payable to “CSNA”


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