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Please add a signature line that includes your District, Name, Club and District Offices Held, and Recognitions from your District or RI.  (Example: 6760-Bill Phillips, Past President x 2, Past AG, Past AG Coordinator, Past Club Foundation Chair, District Foundation Award, Four Avenues of Service Award, PHF x 9, TRF Major Donor, 2004 District Rotarian of
the Year)

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