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P.O. BOX 1004, Cooper Station New York, NY 10276-1004 Enclosed is a contribution of $__________. (Make checks payable to Campaign to Stop Killer Coke.) Name _________________________________________ Title ____________________________
Address__________________________________________________________________________
CITY______________________________ State______ Zip_______________________________
Phone ____________________________ E-mail _______________________________________
Union or Organization (if any) __________________________________________________
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