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To receive information about this form or membership in SWIFA contact:

This form must be received by December 31, 2009 to be included in the member directory,
so fill it out and submit today!

Customer Info:

Company Name:  

Your Name & Title:  

Mailing Address:  

City:     State:     Zipcode:  

Telephone:     Fax:  

Your Email:     Website:  

Classification:     Fabricator:     Supplier:  

Product Description: