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Address 1:

Address 2:

City:  State:  Zip:

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Date Attending: January 10 February 14 March 14 April 11 May 9 June 13 July NONE August NONE September 12 October 31 November NONE December 12

Number of People Attending: 1 2 3 4 5 6 7 8 9 10 11 12

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