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French Cable Station Museum Membership Form

FRENCH CABLE STATION MUSEUM MEMBERSHIP

Name _________________________________
Address _______________________________
Address _______________________________
Email _________________________________

Type of membership

O Life $500.00 O Supporting $100.00
O Contributing $30.00 O Individual $10.00

Date…………………… Amount Enclosed………………

Mail form and check to
French Cable Station Museum
PO Box 85
Orleans , MA 02653