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Text File  |  1990-07-30  |  910b  |  38 lines
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  9.                    ********** BKInput Registration form **********
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  11.           Name of registrant: ____________________________________________
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  13.           Address:            ____________________________________________
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  15.                               ____________________________________________
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  17.                               ____________________________________________
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  20.           Contact:            ____________________________________________
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  23.           Phone:              _______________
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  26.           Amount paid: $ ___________ ($20 ea.)
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  31.           Mail this form, along with payment to:
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  33.                                      Bill Hewitt
  34.                                   7868 NW 7th Court
  35.                               Plantation, FL 33324-1410
  36.                                 Voice: (305) 473-0938
  37.                                  Data: (305) 476-0151
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