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Name(s) ______________________________________________________________________________

Street Address (Towns County) ______________________________________________________

City & Zip Code_______________________________________________________________________

Phone ________________________________________________________________________________

E-mail (TCCA uses BCC for mailouts) ________________________________________________

Out of Towns County Address, City, State and Zip: ___________________________________

_________________________________________________________________________________________

Cell Phone/Home Phone ______________________________________________________________

Your check can be mailed to: TOWNS COUNTY CIVIC ASSOCIATION PO Box 455, Hiawassee, GA 30546-0455

The membership fiscal year is July 1 to June 30.

One year membership dues - $25.00, or two year membership dues - $50.00.

www.townscountycivicassociation.com

email: townscountycivicassociation@gmail.com

Paid: Check # ___________ or Cash $___________