2003 Mike McLaughlin Fan Club
Please print and fill out form and mail to:
Mike McLaughlin Fan Club
P.O. Box 45
Waterloo, New York 13165
| First Name | Last Name | Date of Birth |
| 1. | ||
| 2. | ||
| 3. | ||
| 4. | ||
| 5. | ||
| 6. |
Street___________________________________________________________
City_______________________ State__________ Zip__________
Membership Fees:
| Individual Membership: | $20.00 | Total:_____ |
| Additional Family Members: | $5.00x______ | Total:_____ |
| Out of USA please add: | $5.00x______ | Total:_____ |
| Check/Money order #: | _________ | |
| Total Money Paid: | _________ |
Note: Additional family members must be of the same address.
Payment: Please send check or money order payable to the Mike McLaughlin Fan Club.
The Fan Club asks that when sending items to be autographed to please enclose a self addressed envelope with sufficient postage.
Thank you.
Please print and fill out form and mail to:
Mike McLaughlin Fan Club
P.O. Box 45
Waterloo, New York 13165
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