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YES, IT IS A LONG FORM, HOWEVER, WE NEED TO KNOW EXACTLY WHAT YOU NEED.  PLEASE BE AS SPECIFIC AS POSSIBLE DESCRIBING WHAT YOU ARE IN NEED OF.  PLEASE BE SURE ALL OF YOUR CONTACT INFORMATION IS FILLED OUT SO WE CAN GET IN TOUCH WITH YOU.  MOST OF THE BOXES ARE MANDATORY.  IF YOU PREFER, YOU MAY EMAIL PAT DIRECTLY AT: PWALSHREST@aol.com

WE DO NOT SELL, SHARE, SHOW, ETC...ANY OF YOUR INFORMATION WITH ANYONE.  TWO PEOPLE WILL SEE IT...THE OFFICE MANAGER WHO PRINTS IT OUT, AND THEN GIVES IT TO PAT.  THAT'S IT.  NOBODY ELSE.