Membership
Membership dues are $45.  Checks can be sent to CCS-QCA, PO Box 6184, Rock Island, IL 61204.
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Email *
Today's date *
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Is this a renewal of membership or a new membership? *
Name (First and Last) *
Street Address *
City *
State and Zip Code *
Phone Number *
Church Affiliation *
Please mark all areas of interest *
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How did you hear about our Christ Child Society Chapter?
I have read and understand the Respectful Engagement Policy. *
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