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participation form
Please provide the following contact information:
Name Title Organization Street Address Address (cont.) City State/Province Zip/Postal Code Country Work Phone FAX E-mail URL
I am happy to help Friendship Corps. I hereby donate the following for the Dream Auction. I understand that the proceeds will be used only to fund programs for the medical and educational missions.
Expiration Date: (Must be valid for at least a year)Enter the date of ... :
tHANK YOU FOR YOUR HELP!
December 7 - 10, 2011 -- Albuquerque, NM Contact Us Connected International Meeting Professionals Association (CIMPA) 8803 Queen Elizabeth Blvd, Annandale, Virginia 22003 USA Tel 1 512 684 0889 Fax 1 267 390 5193 Email us
