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An Irish Public House 2606B Raeford Road Fayetteville, NC 28304 Membership Application Membership Dues: $ 5.00 Per Year (All the following info is required by ALE) (Please Print Except Signature) Name _________________________________________________ Address________________________________________________ City, State, Zip_________________________________________ Home Phone_________________ Work Phone_________________ Email__________________________________________________ Date Of Birth____________________________________________ Occupation_____________________________________________ Employer______________________________________________ Music Preference________________________________________ Pool, Darts, Foosball ??___________________________________ Signature_______________________________________________ Date___________________________________________________ ------------------------------------------------------------------------
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