URBAN LEAGUE OF LOUISIANA CORPORATE MEMBERSHIP

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Date:

CONTACT INFORMATION

Company Name
First Name
Last Name
Title/Position
Primary Mailing Address
City
State
Zip
Country
Phone
Email

PROCESSING YOUR MEMBERSHIP DUES

ItemQtyTotal
Corporate Membership1500.00
Annual Charge $xxx

Once you hit submit you will be taken to the PayPal website to complete your membership payment.  Thank you!

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