Membership
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Name ;
Address ;
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State or Prov. ;
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Phone # with area code;
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Rotary Classification ;
Your Rotary Club ;
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Membership Fees you can afford ;

Membership Fees $25.00 Cdn $25.00 US

ROSS VENTRCEK Sec/Treas.
106 MEIGHEN MEWS STRATFORD,
ONTARIO, CANADA N4Z 1B5
Phone (519) 275-2590
Fax - (519) 271-3669
Email to Ross

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