Gambling License #:  ___ - ___ ___ ___ ___ ___ (example A-00698)
 
 

Organization Name:  _______________________________________________________________
 

Gambling Manager:  _______________________________________________________________
 

Address:  _______________________________________________________________________
 

City/State/Zip:  ___________________________________________________________________
 

Gambling Manager Phone:   (        )                           Organization's Phone:   (        )
 
 

Membership Year:

Renewals - 12 months from expiration date of 1997 membership.

New - 12 months starting with postmark month on return envelope with form & dues.

Are You An ACM Member?  (If Not You Should Be!)
 

In order to verify if you are a Current Member of Allied Charities of Minnesota (as of

6/26/98) or to see expiration date just look at the mailing label on page 16 and compare to

the samples below.