eIle IockoFf
"""",,-r= .50 .50
&:ntri»t Pilt:aZ
SW'JGU06s
~6oon{
9~.AunSoue
ouc of
$1.50
'2.50
""""DB
;,,&, ~M"r;",· .
the fiRSt:
DOW"
~huf~en-
wrlIi thoIa IIjJamisk tr--
saUUj ~h, wr::stux.,
c~ • ..-ddG,~
~tr~,,",,"tr a-.1lX~ tl.75
IlE!'!BEltSHIP APPLIC ATIO!f 1 "eAh, !OAk • • pplleaUon for .nb~",hlp In
J . Patric k O'Mal 1, y' . and If ,,,,It ted I a«r,. to , hid,
ttle. llU9h pl.,AtteR
fwP"'"'fiU> '2.05
by all rul .. , rflsu la Uona and by- I e ... of the club , wd l • • the f ollowl nll tu... &ltd conda\"""
ttIe oMAUevt pi.,A.tU!R.
1.
UpOn 'pproval of till • • ppll c alion , I IS["1O" t o poor the l UI of h O do U , " ($2. 00) .... aub,nlllp f ....
4.
lta.bl l'IIh l p . ,
y,ilkjr'.tjerri¥ $2.35
&8
cf.;a'f~
C",!"7Jd",,, ;2.75 DiHne""'" .75
tl1erro""'_
7tutu9J f1..wtAHd"I", -
ru u. NA ill (Print )
S1.W tr_ ~~
rJ,ib .... ~ ;,;...t,.--....,
PCain.. (I=<.-
...... uta 'CyAE out:
$175
,1.95
~
JWK,trCJr.wc,. '$2.15
ctl€ 9"10 zq<e 1)e~fCtL,
~ 9a~
·75
.50
be ... voked . ltho~ t noti c e o r .... r"'." In cu .. of a h conduct.
.25
.55 gWi'JiQ. .W~' .25 .75 Mil., .75 .W Bar .40 .65
"'ft"'"'"
"''''''
DATE O~· BIRTH
IDlE PHOIIE
SPOISlS ""I'n.: BlISINESS ADDRESS
EllPLOYID J Y
""'" "
lIOII LONe EPlPLOI'ED
",
SO
CARD NO. _ _ .pproYed By