INGA MEMBERSHIP FORM

DUES $7/YEAR, OCT. 1 TO SEPT. 30.  LIFETIME MEMBERSHIPS, $100.00

New Member (  )    Lifetime (  )    Renewal (   )    Address Change (  )

Name ________________________________________

Street ________________________________________

City, State, Zip _________________________________

Email address __________________________________

Please sign me up for the INGA email list

Spouse's name _________________________________

Date _______     Phone ___________________

Please print, complete and mail this form, including your check made payable to INGA.   Send to our Treasurer at:

        JAMES JONES
        6433 S HARRISON ST
        FT WAYNE IN 46807

 

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