MEMBERSHIP APPLICATION
FOR
UNION
CAMPGROUND
CEMETERY
ASSOCIATION, INC.
Name ___________________________________________
Address _________________________________________
__________________________________________
Phone number(s) ___________________________________
Email Address _____________________________________
Individual ($15) membership ___ Family ($25) membership ____
Do you have any family members buried at the cemetery (and who)?
________________________________________________________
________________________________________________________
How did you hear about our organization? _____________________
________________________________________________________
Please copy this form and mail it and your check to:
Pansy Harvey,
Treasurer Union Campground Cemetery Association 3822 E.
State Hwy. AA Springfield, MO 65803
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