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Application

Friend of the  Regional Planning History Group

Name: ________________________________________________________________

Address: ______________________________________________________________

______________________________________________________________________

Phone No.: _________________________ E-Mail: ___________________________

To become a supporter of the LARPHG print and send in the completed form with a check for 2007 to LARPHG, PO Box 5905, Pasadena, California  91117.  Your tax-deductible contribution is:

                        Student:  $15.00            Retired:  $20.00              Employed:  $25.00

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