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2. First Name*
3. Last Name*
5. Address1*
7. Address2
9. City*
10. State*
11. Zip*
13. Telephone
14. E-mail
16. Type of Membership
    -- Select One --Individual $10.00/yrFamily Membership $50.00/yrLifetime Member $100.00

18. Once you have submitted the form, you will be redirected to the Decatur Library Foundation's Paypal page for you to complete the membership process.

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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

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