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1. Name (Last, First): 2. Address: 3. Address2: 4. City: State: Zip Code: 5. Telephone: 6. Fax: 7. E-mail: 8. Dedicate book to:
Or Send check or money order payable to: Linda Fischer 1603 Green Branch Georgetown, TX 78626 Phone: (512) 635-4964 email: fischer100@suddenlink.net