E.A.R.S. Membership Form 2010

      Call      
      Name      
      Address   
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      License Class:

Annual Membership Dues:
$10.00 Single, $15.00 Family, $5.00 Senior(over 65)
     Type of membership:

List Family members below:(Family Membership)

Make checks payable to E.A.R.S. and mail to:
                                        E.A.R.S
                                        PO Box 674
                                        Ephrata, PA 17522


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