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Please use this form to register for CNY Air and Waste Management Association's January 19 Dinner Meeting at Justin's Grill.


Name :
Company :
Telephone Number :
E-mail Address :


Will you be bringing a guest ?		 Yes No
If yes, how many guests :


Are you a CNY A&WMA member ?		 Yes No
If the answer is "No," please become a member today.


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