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Change of District Request
(To transfer your membership to SEANC25: complete, sign, and return this form to Tommy Griffin, CB1800, Carolina Campus) |
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Name
(please print): ______________________________________________
SSN: _______________________________________________
Transfer my membership from District # _____ (if known) to District #
25
_____________________________________
Signature
If you prefer not to supply your SSN, you may contact:
Jean Rhodes at SEANC’s Central Office in Raleigh: