Friendship

Please leave your name and address on the below form.

We'll send you a birthday card and Christmas card with coupon.

　

                   MISS   MS   MRS.   MR.

　

First Name                Last Name      

Address (Street)  

City: State: Zip:

Phone:   ()-

Birthday:   Month/ Date /Year

E-Mail:

Web Site:

                                                   New                Address change

                                                                                 

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