Abilene A&M Club
P.O. Box 884
Abilene, TX 79604

(Print this page and send in with your check)

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Annual Dues for the year ____________	$          35.00
A&M Scholarship Fund (Voluntary)	$ _________
Amount of your check	$ _________

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Name:_______________________________________ Date: ___________________

Address: ____________________________ City: _______________  Zip: ________

E-mail: ______________________________________________

Home Phone: _______________________ Work Phone: ______________________