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Directory Results for African American Leaders for Tomorrow Medical Permission Slip July 2326, 2014 CSU Dominquez Hills Campus Name: Date of Birth: Address: City: State: Zip: Home Phone: Cell Phone: Email Address: Parent/Guardian Name: Alternate Contact to African American Leaders for Tomorrow Photo Release July 2427, 2013 CSU Dominquez Hills Campus I hereby give permission to the news media to photograph/interview my child for the African American Leaders for Tomorrow Program - blackcaucus -