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PTBNA MEMBERSHIP FORM - APRIL 05/06

Print out the form then fill in and mail to
Dick Russell 11 Gibbons St. Milton, MA 02186

Name
Address
Phone#
$5.00 per person Total enclosed

Do you have time to be involved in PTBNA issues Yes___ No___

Do you have a computer Yes___ No___ Email Address _____________________

News and Views I would like to share:

 

 

 

 

 

Since some things are better or easier said than written, feel free to call Dick with
issues, News, or Views/ (617 696 3751) or email at: dickrussell@pinetreebrook.com