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2. First Name
3. Last Name
5. Photo Date

   1. Thursday, September 28
   2. Friday, September 29
7. Please choose one of these backgrounds for your photo:

   1. Green tree/shrub
   2. Courthouse pillar/facade
   3. Norristown view from atop Cherry Street garage
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9. 1. Receive an email copy of this form.
10. Email address

    This field is not part of the form submission.

11. Submit

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