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Monday, October 13, 2008  
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Membership - Membership Form

Here's how you can join! Please complete this form to become a member or request more information. Make checks payable to Brucemore, Inc., 2160 Linden Drive SE, Cedar Rapids, IA, 52403. Call 319-362-7375 for more payment options.
*First Name
     		 *Last Name
Company
Address
City
State
 Zip Code
*Email
*Email Confirm
Phone Number
Fax Number

I would like to become a Personal Member:
  $35 Individual
  $50 Household
  $100 Patron
  $250 Donor
   $500 Benefactor
  $1,000 Trustees Club
  $2,500 The George and Irene Douglas Circle
  $5,000 The Howard and Margaret Hall Heritage Club

I would like to become a Corporate Member:
  $250 Corporate Donor
  $500 Corporate Benefactor
  $1,000 Trustees Club
  $2,500 The George and Irene Douglas Circle
  $5,000 The Howard and Margaret Hall Heritage Club
Comments and Requests
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Membership
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2160 Linden Drive SE, Cedar Rapids, IA 52403 · Phone: 319/362-7375
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