HARA Membership Application
Renewal or New Member

Type of application: _____ Renewal _____ New
Name:  _____________________________________
Street Address:  ___________________________
City:  _____________________________________
State:  ________ Zip +4: ___________________
Phone Number:  _____________________________

Membership fee is $10.00 per year.
Mail your check, made payable to HARA, and this application form to:

HARA
Attention: Membership
P.O. Box 881835
Los Angeles, CA 90009-3013

8/03

Office use only: Date Rec. _______ No. Yrs _____ Renewal ___
New ____" NM pkg ___ List ______: Ledger ______Computer