$25.00 per Family
$150.00 Lifetime membership
Annual membership dues payable to:
GLWM/Irish American Club
451 Kenwood NE
Grand Rapids MI 494
Date: _______________
Name: ________________________________________________
E-Mail address: _________________________________________
Address: ______________________________________________
City: ____________________ State: ________ Zip: ____________
Phone: ( ) ___________ Amount Enclosed:_________________
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