Ottawa County Patriots
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Memberships
Membership is open to anyone who supports our mission statement
Name
(Required)
First
Last
Phone Type
Cell
Home
Business
Cell Phone
(Required)
Home
Business
Email Addresses
Personal
Spouse/Family Member
Business/Other
Personal
Spouse/Family Member
Business
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Member Benefits
Standard, Supporting, and Patron are one time gifts. Contributing gifts are monthly.
I want to give:
Monthly
Annually
Memberships
Contributing
Memberships
Standard
Supporting
Patron (2 year membership)
Annual Membership
Single Member
Married Couple
Family Membership
Contributing Membership
Monthly due will be automatically paid.
Single Member ($5)
Married Couple ($10)
Other
Contributing Membership - Other Amount
Special Annual Membership
Single Member
Married Couple
Family Membership
Credit Card
Card Details
Cardholder Name
Total
Name
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