POINTers
in Person
Musmanno Chapter
Pittsburgh,
Pennsylvania
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POINTers in Person “PIP” Chapter 20 Application Form If
you are interested in joining the Pittsburgh Chapter of PIP please
complete the following information and send it to the following address:
POINTers In Person (PIP) c/o Rosemarie Laudato, 161 Deemer Drive,
Pittsburgh PA 15234-3201
Date:___________________________ Name: _____________________________________ Address: ____________________________________ ____________________________________________ City ___________________ State _____Zip _______ Daytime phone: (_____) - ______-_______________ Evening : (_____) - ______-_______________ FAX number : (_____) - ______-_______________ Email Address:_______________________ RESEARCH INTEREST Paternal surname: _____________________ Town or City ______________________ Province: ___________________________ Region____________________________
Paternal surname: _____________________ Town or City _______________________ Province: ____________________________ Region____________________________
Maternal surname: _____________________ Town or City _______________________ Province: ______________________________ Region__________________________
Maternal surname: _______________________ Town or City _____________________ Province: ______________________________ Region___________________________
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Copyright
2002 PIP Chapter #20
For technical assistance support HERE
Last
updated 10/14/04