| First choice (greatest interest) |
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Willing to lead this effort?
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| Second choice (next interest) |
|
Willing to lead this effort?
|
| Third choice (next interest) |
|
Willing to lead this effort?
|
| Want to add a group that is not listed?
If you wish to suggest another group please provide a very
brief statement about that group here. |
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Willing to lead this effort?
|
| Attendance at WFS 2008 Meeting
in Washington, DC? |
|
| Your Name |
First
MI
Last |
| Your
Organization |
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| Your preferred Email Address (essential) |
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Postal Address
Line 1 |
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Postal Address
Line 2 |
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| City, State Postal Code |
City
State Postal Code |
| Country |
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| Preferred Telephone
numbers: |
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| Cell Telephone |
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| Other Telephone |
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| Today's Date |
Month
Day Year
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Important: Please indicate your agreement -
"I give my permission to share my name, postal address, and email
address with other futurists to promote futures learning." |
Your reply:
Your initials
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