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* 1. Name

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* 2. Position or Job Title

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* 3. Address

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* 4. City, State, and Zip Code

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* 5. Phone Number: Office

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* 6. Fax Number: Office

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* 7. E-mail Address

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* 8. Do you need CRC credits?

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* 9. For further information, please contact:
Dr. Alo Dutta, Associate Professor
Department of Rehabilitation and Disability Studies
Southern University, 233 Blanks Hall
Baton Rouge, LA 70813
Phone: 225-771-2335
Fax: 225-771-2293
E-mail: alodutta1992@aol.com

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