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Membership Application
Mile High Hook & Ladder
Membership Application
Name: _________________________________________________________________________
Spouse/Children Names: ____________________________________________________
Address: ______________________________________________________________________
City: _________________________ State: _______________ Zip Code: _____________
Email: _________________________________________________________________________
Phone Home: _________________ Work: _______________ Cell: _________________
Fire Apparatus: ______________________________________________________________
Other Interests: ______________________________________________________________
Permission to publish contact information to Club Members? Yes No
Membership Type: _____ Individual $20.00 _____ Family $25.00
Send application and dues to:
Mile High Hook & Ladder Club
Sharon Sells, Treasurer
PO Box 1683
Eastlake, CO 80614
