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I wish to renew my membership or join the AARP Campbell Area Chapter 5151. I have included a check for my annual chapter dues which include our newsletter, The Dispatch.  Membership fee is $20 with the Dispatch sent by regular mail.  If you would like your Dispatch sent via e-mail, membership fee is $15, which includes a $5 discount, as we save on printing & mailing costs.  I am a member of the National Organization.

National No. (Required) : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  Expiration Date:. . . . . . . . . . . . . . . 

E-Mail Address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Amount Paid  $ . . . . . . . . Check #. . . . . . . .

NAME:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [  ] New Member* (see below)

ADDRESS:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  [  ] Renewal

CITY:. . . . . . . . . . . . . . . . . . . . . . .. . . . . . . STATE:. . . . . . . . .ZIP CODE: __ __ __ __ __ — __ __ __ __

PHONE: (. . .. . . .) . . .. . . . . . . . . . . . . . . .SIGNATURE:. . . . . . . . . . . . . . . . . . . . . . . . . . . DATE . . . . . . . .

 *How did you hear about our chapter? _________________________ Age Group? 50-65 (  )  66-75 (  )  76+ (  )

Please make checks payable to AARP Campbell Area Chapter 5151. 

Mail to: Membership App, 2643 Meta Drive, San Jose, CA  95130-2231.