Use this handy coupon to register.

NAME_______________________________

ADDRESS___________________________
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PHONE______________________________

  RETURN AND MAKE CHECKS PAYABLE TO:
Steven E. Williams
P.O. Box 333
Millerton, NY 12546
Empire Safety Council
Approved Instructor #CYK


CLASS DATE_________________________________

$40 INDIVIDUAL PREPAID_____________________
$45 IF PAID AT DOOR. HOW MANY?_____________

Names________________________
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Phone__________________________
Phone__________________________
Phone__________________________