Paid No. ______________
Date _________________
Mbr No. ______________
Date _________________
German Coolie Society
and
Registry
 | Submit this application with appropriate fee | |
| Send Check or Money Order, email for more | |
| information about sending payment via paypal, to the IGSC&R Business Office |
IGCS&R Business Office
Ida Parmer
1139 LCR 454
Groesbeck, Texas 76642
(254)562-3078
www.coolieregistry.com
| Individual |
Family |
Lifetime |
| $10.00 yrly |
$20.00 yrly |
$100.00 |
| Individual |
Address |
Family |
Address |
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| Name |
Name |
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| Name |
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| Name |
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