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The United States Police Canine Association, Inc. Application for membership 2010 REGION #6 DISTRICT IS THIS A DUAL MEMBERSHIP? Yes no Name Address Home Phone — City State Zip Email Police/Military/or

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1. Start by accessing the official website for US Patent and Trademark Office (USPTO).
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7. Review all the information you have entered for accuracy and completeness.
8. Once you are satisfied with your answers, sign and date the form as required.
9. Make a copy of the completed uspcamemdoc for your records, and submit the original to the USPTO as instructed.

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