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Template Demonstration
Personal Account Information
Move between fields with the TAB, Up and Down arrow keys.
ONLY when you have completed all of the fields, press the RETURN key.
Use Control-L to refresh the screen. Use Control-X to abort.
First Name [________________________________________]
Middle Name [________________________________________]
Last Name [________________________________________]
Daytime Area Code & Phone Number [____________________]
Institution Name [________________________________________]
Institution Street Address [________________________________________]
Institution City, State, ZIP [________________________________________]
Is this address in the U.S.A.? [_] Y or N
---Fields marked with "*" are required!
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