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  1. Name(*)
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  2. Address(*)
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  3. City(*)
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  4. State(*)
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  5. Zip(*)
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  6. Phone(*)
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  7. Email(*)
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  8. Cell
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  9. Web Site
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    10. Payment Information




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    12. My volunteer contribution to the Guild this year will be:





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    15. Information on where to send your check will be contained in the email sent to you upon submission of this form.