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JRCC Membership
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Please note: Due to AMA insurance requirements, all applicants must show a current AMA card PLEASE PRINT NAME:___________________________________________________________ AMA Number:_____________________________________________________
CITY:____________________________________________STATE:__________ ZIP:_____________ Cell PHONE:______________________________
DATE:___________
E-MAIL ADDRESS:_________________________________________________
2010 DUES ARE TO BE SUBMITTED WITH APPLICATION.
PLEASE send completed application* with dues attached to: Mark Harris Jackson, Michigan 49201 |
January Club News in Brief
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