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		PEANUT PALS  APPLICATION FOR MEMBERSHIP Annual dues are $20 for primary members, dues are for Oct.1, until Sept. 30. Dues for associate memberships are available for $10, age 16 and older.  For other individuals of the  primary member's family, under the age of 16, dues are $3. Newsletters and other mailings are sent to primary members only. Print this form, fill out and send to:                                                                    Ruth Augustine                                                                  PEANUT PALS                                                                             6052 Canter Glen Ave.                                                                                Las Vegas Nevada 89122 NAME (Primary Member)_________________________________________________    $20.00  ADDRESS ___________________________________________________________________  CITY ___________________________ STATE  _____________________ ZIP _____________ PHONE ________________________________   COUNTRY  ___________________________  ASSOCIATE MEMBER @ $10 Each (16 or older) @ $3 Each (15 or younger). NAME ______________________________________________________  $______________  NAME ______________________________________________________  $______________ NAME ______________________________________________________  $______________ Total Amount Enclosed  (In U.S. Currency)                                                                                                            $______________ Make Check / Money Order Payable to Peanut Pals Checks / Money Orders must be in U.S. Funds, payable through a U.S. bank or post office. Permission to List Name and Address in the Directory?                          Yes _____     No _____  Permission to List Phone Number in the Directory?                                Yes _____     No _____ Permission to publish your e-mail address in membership book?         Yes _____     No _____                             Your e-mail address is?_____________________________________________ How did you first hear about Peanut Pals? _______________________________________