HJEO MEMBERSHIP APPLICATION

					     DATE:____________

NAME:_________________________________ BIRTHDATE (JR/AM)______

ADDRESS:______________________________________________________

CITY:______________________________ STATE:_____ ZIP:__________

PHONE:(____)___________  (___)___________ FAX (____)__________

For Family Memberships Only: List Names and Birthdays

NAME: ________________________________ BIRTHDATE:_____________

      ________________________________		 _____________

      ________________________________		 _____________

CIRCLE ONE:   JUNIOR $15   ADULT $15   FAMILY $30

MAIL TO:	Karen King, 4323 E. 99th Street, Tulsa, OK 74137
		Phone: 918-299-1596 (Home)
		Membership active from Dec.1 to Nov.30.