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             Print and Use this Registration 
              Form 
            Unit #               
            How Many Scouts?                 Adults? 
                             @ 
              $15 each  =  $              
            Make 
              Check payable to GNYC/BSA 
              
            Please mail this form by October 6, 
              2003, to 
                Fran Falk 
                90-60 209th 
              Street 
                Queens Village, 
              NY 11428 
                Call (718) 479-9541 
              for more information 
            Acct #1-6801-049-20 
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