Please check:
| ____ New Member | ____ Renewal | ___ Donation |
MEMBERSHIP APPLICATION: Please write legibly, preferably in capital letters, and mail it with a check made out to ARCC to
ASSOCIATION FOR THE RIGHTS OF CATHOLICS IN THE CHURCH
3150 Newgate Frive
Florissant, MO 63033
U.S.A.
Salutation (Mr/Mrs/Ms/Sr/Br/Rev/Dr): _______
Last Name:____________________________
First Name:____________________________
Middle Initial:________
Address:_______________________________________________________________
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City:____________________________ State/Prov:_____ Post Code:_______________
Country:_______________________________________________________________
Phone #: (_____) _______________________
Fax #: (_____) _______________________
Email: ______________________________________________
Membership enclosed:
| ___ ARCC Angel ($100) | ___Regular Member ($50) | ___ Senior Member ($25) | ___ Student Member ($15) |
Tax Deductible Donation:____________________
Total payment enclosed: ______________________
Any comments or information about yourself that you would like to share with us:
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