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Name __________________________________________________ Address ___________________________________________ Phone __________________ City ______________________________________ State _______ Zip _________________ Please accept my application for membership in the Seneca Sprockets Bicycle Club, a nonprofit group organized to promote bicycling as a source of fun, fellowship and fitness. Signature ______________________________ _____ Individual Dues $7.00 _____ Family Dues $10.00 Individuals eligible for membership must be at least 18 years old. Dues are renewable each year at the April meeting. Please enclose your check, payable to "Seneca Sprockets" and return to Seneca Sprockets Bicycle Club, P.O. Box 96, Tiffin, Ohio 44883. |