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Northern Kentucky Bluegrass Music Association Membership Application Membership Fees per Year: Single $12.00 Couple $15.00 Band $25.00
Name_____________________________
Address___________________________________
City State_________________________________
Zip Code_____________
Telephone_________________________
Birthday Month______________
Spouse Name_______________________
Spouse Birthday Month_______________________
Anniversary Month__________________________
Membership Type: Single__________ Couple___________ Band________
Paid By: Cash______ Check_______
Special Talents: Musican________ Computer________ Other________
Date___________________
Email ___________________
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