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[th-contact-form subject=”Help request from user for Rotary Institute Registration Form Submission” to=”debbie.lefore@bussysconsulting.com” button_text=”Send”] [th-contact-field type=”name” required=”true” /] [th-contact-field type=”email” required=”true” reply=”true” /] [th-contact-field label=”Home Phone” type=”text” /] [th-contact-field label=”Cell Phone” type=”text” /] [th-contact-field label=”Work Phone” type=”text” /] [th-contact-field label=”District” type=”text” /] [th-contact-field label=”Rotary Club of:” type=”text” /] [/th-contact-form]