CHRISTIAN LEGAL REFORMATION CLUB
Prepaid Radio Form
First Name
Last Name
Dominant Biological Background
Race or subrace
pick below
Nordish
White, not Hispanic, not Oriental, not Southern European
German
French
Anglo Saxon
Not of Northern European Descent
Please type at least one in:
*
Email Address
Street or
P.O. Box
City
State or
Province
Country
Zip
Phone
Fax
Comment or
Message
Please mention:
Radio Station
Call Letters
and
Whom to Ask For.
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