Name: _______________________________________________________
Address: _______________________________________________________
______________________________________________________
Phones: Home ____________________ Work: _____________________
E-mail: ________________________________________________________
(Check one:)
___ Active membership ($25.00) ___ Inactive membership ($6.00)
Please make check out to: WMBC
and mail to: Jane
Harrelson
1151 Parnell Ave SE,
Ada MI 49301
Or bring to any meeting or workshop.