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2. First Name or Initial*
3. Last Name*
5. Phone*
6. Email*
8. Title of photograph.*

   The theme is "Burleson, A Day in the Life".  The Title will be displayed next to the photo with your name.

10. Upload your .png or.jpg file here.*
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12. 1. Receive an email copy of this form.
13. Email address

    This field is not part of the form submission.

14. Submit

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