Test (deleteme)

Newsletter	Would you like to receive our Newsletter via postal mail?
Salutation
First Name
Middle/Maiden/Previous
Last Name
Address 1
Address 2
City
State
Zip Code
Phone	Your primary contact number
Email	This is the email address we will use to send the Newsletter, if you chose to receive it by email.
Code
Work Code #
State Membership
Status
Date of Birth	mm/dd/yyyy
Date of Death	mm/dd/yyyy
Comments
Name/Location of Company Worked	Where did Rosie work?
Dates of Work	When did Rosie work?
Type of Work	What work did Rosie do?
Rosie Name if Rb or Rv	If new member is a RB or RI what is the Rosies Name and Relationship

First Name	Last Name	City	State
Roberta E	Hite	Kokomo	IN
Joan Ott	Sebastian	Rochester Hills	MI
Patricia Yvonne Sergent	Robinson	Gallipolis Ferry	WV
Leonard Donald	Sergent	Henderson	WV
Alaina Lea	Pecoraro	Slidell	LA
Dennis A	Harbour	Springfield	OR
Timothy C	Harbour	Springfield	OR
Orene Lambert	Lea	Kentwood	LA
Roslyn Lea	Varnado	Kentwood	LA
Beverly Drew	Leach	Montevallo	AL