To: fostermiller3199@comcast.net
Subject: Love-Air R/C Membership
cc: rsothen@msn.com

First Name- [FirstName]
Last Name-- [LastName]
Street----- [Street]
City------- [City]
State------ [State]
Zip-------- [Zip]
Phone------ [Phone]
Birthdate-- [Birthdate]
AMA-------- [AMA]
E-mail----- [EMail]
Freq1------ [Freq1]
Freq2------ [Freq2]
Freq3------ [Freq3]
Freq4------ [Freq4]
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