SWIGER RUN HISTORY LIBRARY

 

MEMBERSHIP APPLICATION

 

 

 

 

                                                            NAME

 

____________________________    _________________  _________      _____________

            ADDRESS                                           CITY                 STATE                ZIPCODE

 

____________________________    (   )  NEW MEMBER   (   ) RENEWAL

            PHONE #

 

 

$   _________________________  AMOUNT ENCLOSED

 

I AM INTERESTED IN THE FOLLOWING FAMILIES, COMMUNITIES, ETC.

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MAKE CHECKS PAYABLE TO:

SWIGER RUN HISTORY LIBRARY

RT. 2 BOX 206

SALEM, WV 26426

ATTN:  ANNE MISH, DIRECTOR