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Panhandle CHA 2004 Membership Application
Please print out the following application, fill it out, sign it, and mail along with your dues to:
Sophie Feger
HCR 3 Box 71A
Perryton, TX 79070
Name____________________________________
Address___________________________________
City, State, and Zip___________________________
Email Address______________________________
SS#______________________________________
NCHA#___________________________________
Single - $25_______
Family - $35______
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