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Bethel Hall of Fame Membership Form
Annual dues are $40 a year (Jan-Dec)
Name
First
Last
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Home Phone
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###
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####
Cell Phone
###
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###
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Email
Confirm Email
Number of Memberships I'm purchasing
Each membership is $40 a year.
Number of Lifetime Memberships I'm purchasing
Each membership is $200.
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