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Gather Us Together
RESERVATION FORM FAX TO: 323.761.8647
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| Date of request:_____________________________________________________ |
| Kit is needed for the following weeks:___________________________________ |
| Month/Date/Year_________________through Month/Date/Year______________ |
| Who will be picking up the materials on:_________________________________ |
| I will return the kit on:________________________________________________ |
| Month/Date/Year:___________________________________________________ |
| Name and phone number of the responsible party with whom to communicate regarding the the kit:_________________________________________________ |
| School/Org. Phone Number__________________________extension_________ |
| School/Org.Address_________________________________________________ |
| Email address:_____________________________________________________ |
| Cell phone numbers:________________________________________________ |
NOTES: Please bring in your fee of $60.00 when picking up this Ethiopian Resource kit.
Fax : (323) 761-8647
Phone: (323) 761-8644
resource@jclla.org