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RECURRING PAYMENT AUTHORIZATION FORM 5446 N. Academy Blvd., Suite 104 Colorado Springs, CO 80918 (719) 2320157 Date: First Name: MI: Last Name: Mailing Address: City: State: Zip: CREDIT CARD INFORMATION
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The purpose of the membership form - soothing is to gather information from individuals who are interested in becoming a member, so that the organization or group can keep track of its members.
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