Print this form and return with check payable to:
Ann
Croston
38 Padanaram Ave B-18
Danbury CT 06811
Name______________________________________________#__________________________
Address_______________________________________________________________________
Address________________________________________________________________________
Address________________________________________________________________________
Amount Enclosed:___________________
(1984) $6.00__________(1991)
$7.00_________(1998) $8.00__________
(1985) $6.00__________(1992)
$7.00_________(1999) $8.00__________
(1986) $6.00__________(1993)
$7.00_________(2000) $8.00__________
(1987) $6.00__________(1994)
$7.00_________(2001) $8.00__________
(1988) $6.00__________(1995)
$7.00_________
(1989) $6.00__________(1996)
$7.00_________
(1990) $6.00__________(1997)
$7.00_________