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CTAA=
Member
Info for Members-Only Directory
Last
Name: ______________________________
First
Name: ______________________________
Birthday:
________________________________
Mailing
Address: ______________________________
City,
State, Zip: ______________________________
Telephone
#: ______________________________
Other
contact phone #:______________________________
Email:
______________________________
Spouse
Name (if applicable): ______________________________
Birthday:
______________________________
Website:
______________________________
Please
enclose $15.00 and mail to:
CTAA
Membership
c/o James Klier=