| Rev. 9/24/01, | |
|---|---|
Cascade Chapter Dues -- 2001 - 2002 | |
| NAME(S)______________________________________________ | |
| . | |
| ADDRESS____________________________________________ | |
| . | |
| PHONE NUMBER__________________________________________________________ | |
| . | |
| NAME OF NON-MEMBER SPOUSE________________________ | |
| . | |
| Amount enclose: ________persons at $5.00 each = $____________________________. | |
| . | |
| Please make checks payable to PSA CASCADE CHAPTER NO. 23 | |
| . | |
| Mail to: | |
| Roland Smith | |
| 1281 SE Laura Drive | |
| Gresham, OR 97080-9171 | |
| Phone: (503) 667-8346. | |
| . | |
| If you want to go back to this months Chatter: click here. | |
| . |