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CENTRAL CROPPER AND POUTER CLUB
MEMBERSHIP APPLICATION
Adult Dues: $10.00 yearly
Junior Dues: $5.00 yearly
Name ___________________________________________________________
Junior ___ Senior ___
Address _________________________________________________________
City ________________________________ State _______ Zip ____________
Phone __________________________ E-Mail __________________________
Breeds / Colors Raised: ____________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Other Club Affiliations: _____________________________________________
_________________________________________________________________
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•Print and cut this page at the line above.
•Send application to: