TO ORDER STATS, COMPLETE THE FORM BELOW.
SPECIFY ELIMINATOR (s) YOU WANT
DONATION: $ 5.00 PER ELIMINATOR
Name:
Address:
Address 2:
City: State: Zip:
Telephone:
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Comments:

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For more information:
East Coast Stock Super/Stock Assoc.
2019 Rte. 206
Southampton, NJ 08088-3530 US
Email: dleyracing@aol.com
609-859-0069

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