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Please fill out the following form. All fields are required.
Customer Number
(If Known)
(On Mailing Label)
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Acronym
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(STREET address to ship Free magazines)
City:
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Zip:
Country:
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Comments, Questions, Additional Information:
(Please include all pertinent foreign contact information
that does not fit in the above form.)
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Box 20219, Portland OR 97294
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