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Please print this form and mail with payment to:
Camaron J. Thomas
P.O. Box 279
Petersburgh, NY 12138
Once your check is received, your copies will be mailed directly to you.
| Name: | ______________________________ |
| Mailing Address: | ______________________________ |
| City, State Zip: | ______________________________ |
| No. Copies: | __________ |
| Price Per Copy: | $16.95 |
| Shipping: | $3.00 |
| Total: | __________ |