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1611 W. Irving Blvd. Irving, TX 75062 972-253-3333 MEMBERSHIP APPLICATION Date: ___________________ Membership Type: ________________________________ $ / Year: _________________ Name: _________________________________________________________ Address: _________________________________________________________ City, State, ZIP: _________________________________________________________ Home Phone: _________________________________________________________ Work Phone: _________________________________________________________ (If family membership, please list all family members) ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Membership Types Available: - Single Membership - $25.00 / Year - Family Membership - $35.00 / Year - Patron Membership - $50.00 / Year - Silver Membership - $100.00 / Year - Friend of the Society - $250.00 / Year - Gold Membership - $500.00 / Year - Platinum Membership - $1000.00 / Year - Life Partner - $5000 - Other - $$$ |