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Please sign and fill in the following information,
write your statement below, and drop the form in campus mail to
Suzanne Sindi, Dept of Math. We appreciate your support!
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I give GALOL permission to use my statement publicly,
and to edit it to fit the context and space limitations
of the document in which it is used. GALOL will make every
effort to maintain its original gist and content.
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Signature:
Name:
Dept:
Contact info (phone/email):
Statement:
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