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Membership Form
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| Last Name |
__________________________________________________________ |
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| First Name |
__________________________________________________________ |
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| Street Address |
__________________________________________________________ |
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| City |
__________________________________________________________ |
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| Province/ State |
__________________________________________________________ |
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| Postal Code/ Zip
Code |
_____________________________ |
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| Home Phone |
___________________ |
Work Phone |
__________________ |
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| Email Address |
_____________________________ |
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| Vocals and Type? |
__________________________________________________________ |
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| Instrument(s)
Played? |
__________________________________________________________ |
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| Any Comments? |
__________________________________________________________ |
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__________________________________________________________ |
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__________________________________________________________ |
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__________________________________________________________ |
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Please enclose a cheque for $20 made (payable to
Ottawa Valley Bluegrass Music Association). |
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Ottawa Valley Bluegrass Music Association |
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Box 4093 - Postal Station E |
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Ottawa, Ontario CANADA |
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K1S 5B1 |
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