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MEMBERSHIP FORM Please Print and Complete One Form Per Person First Name: q I wish to receive the Pacers Club Newsletter Electronically Last Name: E-mail : Address: City: State: Zip: Phone: Date of

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8. If there are any supporting documents required, make sure to attach them securely to the form. This may include photocopies of identification documents, proof of address, or any other requested paperwork.
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Please print and complete refers to a form or document that needs to be printed out and filled in with relevant information.

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The individuals or entities specified in the instructions of the form are required to file please print and complete.

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