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You'll be glad you signed up for this powerful workshop!
Print the form, fill it in, and mail to Wade Luquet 100 South Main Street North Wales, PA 19454. You may also register by phone by calling 215-699-4404.
Date of Workshop I would like to attend ______________________________________
Names_______________________________________________
Address_________________________________________________________
_______________________________________________________________
_______________________________________________________________
Phone (Day)______________________________________
(Evening)___________________________________
How I heard about the workshop___________________________________
Credit Card Type_____________
Credit Card Number_________________________
Expiration date_______________________________________
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