Yes, we/I want to join and support the Minuteman Implant Club. Membership entitles us to receive the newsletter and to
vote at club meetings.
Date: May 11th, 2009
Dues are $15.00 per year. I/We are signing
Your Title & Name:
Person who has implant:
Permission to be listed in MIC member Directory
2CheckOut.com Inc. (Ohio, USA) is an authorized retailer for
goods and services provided by Minuteman Implant Club, Inc..
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