Old St. Ferdinand Shrine Membership Form

Today's Date:

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Online Membership Form

Make any changes and click the "Submit" button.

Be sure to print the confirmation page for your records and one copy to mail with your check.

Please select only one option below:

Individual - $25.00

Family - $50.00

Commercial - $100.00

Life Membership - $250.00

Name(s):

Street Address:

City: State: Postal Code:

Phone Number (please include area code):

Email Address:

Your membership dues are:

If the above information is correct, click the "Submit" button below.

You will recieve a confirmation page for you to print a copy for your records and to print a copy to mail along with your Membership Fee.

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Thank you for joining us in the preservation of the Old St. Ferdinand Shrine!

Friends of Old St. Ferdinand Shrine, Inc.

PO Box 222

Florissant, MO 63032