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For registration, please complete, print, and mail this form to the treasurer of MTSNYS:
George Fisher, MTSNYS Treasurer 22 Watson Lane Setauket, New York 11733
Name: Street Address: City: State: Zip:
Registration: Individual $20 Student $15 Retired $15 Individual (Late) $23 Student (Late) $18 Retired (Late) $18 TOTAL ENCLOSED: $
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