| Funeral Consumers Alliance ~ Channel Cities | |||||
Membership Application
Services
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Funeral Consumers Alliance~Channel Cities Membership Application |
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| Complete this form
and
mail it to: Funeral Consumers Alliance ~ Channel Cities, P.O. Box 6912, Santa Barbara, CA 93160 Please enclose $35 for each adult lifetime membership. A member's children who are under 21 are covered at no charge. |
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| NAME #1 | Birthdate |
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| Social Security Number |
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| NAME #2 | Birthdate |
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| Social Security Number |
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| Phone: ( ) |
Date of This Application: | ||||
| Address:
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| Choice of Mortuary (Must be Included): ( for more information, click here COOPERATING MORTUARIES) |
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| Name and birthdates of minor children:
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