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Please fill out completely: Please Print Name:
_____________________________________________________________ Address:
_____________________________________________________________ City:
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_____________________________________________________________ T-Shirt Size: Circle
One: X-Small
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XX-Large Please enclose $35.00 for 2010 membership. Mail to: FSA 124 5th Avenue
North, Jacksonville Beach, FL 32250 For member benefits or to join on-line using a
credit card please visit: www.floridasurfing.org
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