	MEMBERSHIP APPLICATION AND RENEWAL FORM

Please submit the form, then mail your membership amount due to the following address:
Also attach small piece of white paper: On it,
write "mim membership" include your Full Name, date & signature
MIM Treasurer, C/O Omer Kitaplioglu
122 Salter St.
Springfield, NJ 07081
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*Please fill in the form completely. Fields with a "" are required.**

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We will get back to you regarding the status of your application

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