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Membership Contact Form Print this page or copy it into your e-mail and send it to: The Life Center --- For Phone Number, E-mail and/orPostal Address, See Our Contact Page . |
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Please print Clearly I
am Enclosing a donation to support your
work. (
) Global
Climate Change (
) Bringing Christianity into the
21st Century (
) Ending Global Terrorism (
) How to Save the Last of the
Virgin Redwoods (
) The Separation of Church and
State (
) How
to Create Safe,
Dependable,
Tangible-asset Retirement Funds (
) Gay and Lesbian Rights (
) Protecting Women's Reproductive
Rights ( ) Robert's
Life-coaching
and Success-coaching Services. ( ) Having Robert Speak to Your Group. ( ) Interviewing Robert for Radio or Television. ( ) Interviewing Robert for Print or Web Publication. ( )
Exchanging
Links ( ) Other: Please tell us how we can assist
you. Name:_______________________________________________ Mailing
Address:___________________________________________ City:_____________________
State:__________ Zip:___________ E-mail
Address: __________________________________________ Phone
Number: ___________________________________________ Make
your check or money order payable to The
Life Center For donations by credit card, please go to: http://www.lifecoach4vip.com/029-credit-card-use.html° . . Please share your thoughts and opinions with us. ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ . . . Whom do you know that we should contact: Contact Them Regarding: ( ) Global Climate Change ( ) Bringing Christianity into the 21st Century ( ) Ending Global Terrorism ( ) How to Save the Last of the Virgin Redwoods ( ) The Separation of Church and State ( ) How to Create Safe, Dependable, Tangible-asset Retirement Funds ( ) Gay and Lesbian Rights ( ) Protecting Women's Reproductive Rights Their Name:______________________________________________ Mailing Address: __________________________________________ City:_____________________ State:___________ Zip:__________ Their E-mail Address: ______________________________________ Can we say that you referred them to us _____ YES _____ NO ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ . . . |
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. 14b --- Membership Contact Form http://www.ReligionAndReality.com/14b-member-form.html . . ... |
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