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Name
School Name
	Complete School Name must be filled in above..
Street Address
Address (cont.)
City
State/Province
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I am a teacher, 
     please send me a sample D size holder, specially made for classroom use,
     with rounded corners and Spring Fahnestock Clips and catalog

Please tell us, in the space below, in precise detail, where you found our listing.
Free samples will not be sent without this information.

Thank you!