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Memberhip Application

[_] New                                              [_] Renewal

Name: __________________________________________________

Address: ________________________________________________

City: ___________________________________________________

State: __________  Zip: ____________________________________

Phone: __________________________________________________

Seasonal  address if applicable & dates used:

______________________________________________________

______________________________________________________

______________________________________________________

Membership Dues:

[_]   Annual ... $20.00
[_]   Senior ... $15.00
[_]   Family ... $30.00
[_]   Life (minimum) ... $250.00
[_] Corporate / Organization (minimum) ... $150.00

Please make checks payable to:    OCHGS

Mail to:

OCHGS Membership
114 Dryden St
Hart MI 49420