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Couples Membership Form

HomeCouples Membership Form

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Name *

First

Last

Name (For Name Tag)

Spouse's Name *

First

Last

Spouse's Name (For Name Tag)

Email *

Spouse's Email

Mailing Address *

Mobile Phone Number *

Phone Carrier (required to be able to receive send text messages from the UPZS email)

If other, please list your Phone Carrier

Spouse's Mobile Number

Spouse's Phone Carrier (required to be able to receive send text messages from the UPZS email)

If other, please list your Spouse's Phone Carrier

Comments/Suggestions for the UPZS Club

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