City, State and Country: _______________________________________________
E-mail address: _____________________________________________________
Collection Title: _____________________________________________________________
I certify that this collection is mine, and authorize AFSC to post it on the EXPOCARD website for unlimited time.
However, I can require my collection to be excluded at any time (in this case, I will send you a written requirement).
( ) Collection images CD.
( ) Collection description (optional)
( ) Personal data (optional)
Signed _______________________________________ Date ____________