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O. B. B. A.   R E N E W A L   A N D   N E W   M E M B E R   A P P L I C A T I O N 11/1/00

 

*Name Organization
Mailing Address Ph # (       )
City State Zip                   -
E-Mail Web/URL

Check / One

 

$8 RENEWAL

 

$8 NEW MEMBER

 

$100 LIFE MEMBERSHIP

Today's Date:

 

*STUDENT

 

DONATION/GIFT ~ I am making a gift/donation to help support the efforts of OBBA

(*free for students who volunteer two times at a OBBA Rostered station. (see obba website) Include project supervisor’s signature in place of "Organization")

J Send all requests to Tim Tolford, P.O. Box 157, Liberty, IN 47353-0157 J

~ Make checks payable to "OBBA" ~

 

*All membership information submitted to OBBA remains confidential and is not available to solicitors or other organizations without individual member consent.