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E-mail 	 
Area Cd  Phone  Ext  
Area Cd   FAX  
Address	
City	   State Code    
Zip	
Country  AGE to 21  22-45  46-66  67+

Do you want to be on our mailing list?         YES      NO  

Do you want to hear about new things through email?       YES      NO

Instruments that you play:   Piano    Accordion    Chromatic    Button Box   
                                               Keyboards 
                                               Other 
Your Interests:
       BUY Accordions/Button Boxes       SELL Accordions/Button Boxes    
      BUY/SELL Other         Accordion Sheet Music/Books 
      Accordion Recordings                     Accordion Lessons/Education

Music Interests:

   Jazz      Classical      Standards/Easy Listening      Country      Polkas    

  Ethnic Nationalities  such as...  Italian          Polish        Slovak        Czech
  Bohemian       Slovenian     Tex-Mex     Latin         German       Greek
  Spanish          Jewish          Hungarian    Croation   French         Latvian      

   Other 
  

Please contact me as soon as possible