Membership Application
Please print this page and fax or mail it to: ARC Advocacy & Resource Center
665 136th Ave. # 90
Holland, MI 49424
Fax: 1.616.738.9340
New____
Renewal____
__Annual $25
__Copper $50
__Bronze $75
__Silver $100
__Gold $200
__Other ____
Name_________________________________
Address_______________________________
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Phone_________________________________