SKYDIVERS OVER SIXTY – S.O.S.
Please Print NAME:	Application date:_____________________ POPS #:____________________________ Make check payable to Pat Moorehead, SOS#1. Life-time membership fee:$10.00 Send to: Pat Moorehead, SOS #1 3350 St. Francis Place Long Beach, CA 90805-3854 562-630-5229 skyfunone@aol.com For office use only: SOS# _____________ Membership date: ____________________ Dues Paid:$ _________________________ Additional US Team donation:$ _________
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E-Mail: **Please notify the SOS Office of ANY above 'address' changes**
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NUMBER OF JUMPS: (optional)

20080731