| Name |
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| Address |
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| City |
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State |
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| Zip Code |
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| Telephone |
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Fax |
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| Email |
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| I am willing to serve as: |
| Officer (2008/2009 Term): |
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Secretary |
Treasurer |
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President-Elect |
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| District Representative (2008/2009 Term) |
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District I |
District II |
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District III |
District IV |
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District V |
District VI |
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District VII |
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| Committee Chair (2008 Term) |
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Legislative |
Membership |
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Information |
Program |
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