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__________________________________________________________________________
Do not write above line
I wish to (borrow) (renew) a loan copy of the following item(s) from the Paul Kollsman Lending Library and agree to return it within 14 days after receipt.

1 Author and Title 
2 Author and Title 
3 Author and Title 
Please fill in grade of I.A.S membership 

 Name

 Address

Date     City     Zone     State