Membership Form

  
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Who's Thor

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Your Name:

Email address:

City

Home Phone: (###) ###-####

Work Phone: (###) ###-####
Which membership option do you wish:

$ 25 Couple membership (you and spouse)
$ 15 Individual Membeship

Choose a membership user id and pasword for the members only area:

User id

Password:
Comments:

   
Copyright 1997. No information contained in this document may be reproduced without express written consent of the author.
Last revised: March 21, 1998.