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2495 S. Delaware Street San Mateo, CA 94403 TEL: 6505743247 FAX: 6505743985 CRE D IT CA R D A UT H O R IZ AT I O N F ORM Name/Organization Name: Address: City: State: Zip: Phone Number: Fax Number:
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Indicate the purpose or reason for attending the event, such as showcasing products, networking, or attending seminars.
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If applicable, provide details about the products or services you will be presenting at the event.
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