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19 WING COMO
PACIFIC DIVERS SCUBA CLUB
MEMBERSHIP APPLICATION
PERSONAL INFORMATION
Full Name:Rank / Title:Street Address:Date of Birth:City:Postal Code:Work Tel:Cell :Preferred Email:
Home Tel:
Unit
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Individuals or organizations who are required to pay annual fees of $5000 and $6000, as determined by the specific rules and regulations of the relevant authority.
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