Membership Application
Instructions: Print this form on your printer and complete by hand.
MAIL TO: OLD COLONY BOX 343 NEWPORT RI 02840
along with your check and we will send you your membership material.
NAME______________________________________________
ADDRESS__________________________________________
ADDRESS__________________________________________
TOWN/CITY_________________________________________
STATE_____________________ZIP CODE________-_______
TYPE OF MEMBERSHIP:
REGULAR $25.00____FAMILY $35.00_____LIFE $200______
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