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MEMBERSHIP INFORMATION - STEP 1 of 2
     
  DATE :
REGULAR AFFLIATE AME TRANSFER CHRISTIAN EXPERIENCE
 
1. Marital Status: Single Married
  Date of Birth:
     
2. First Name:
  Last Name:
     
3. First Name of Spouse:
  Joining: Yes No
  Date of Birth:
     
4. Current Address:
  City :
  Zip:
  State :
     
5. Student: Yes No
  High School:
  College:
6. Telephone(s):  
  Home:
  Cell:
  Work:
     
  a. Spouse Cell:
  b. Spouse Work:
     
7. Email Address:
  Spouse Email:
 
 
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