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Registration Form
South Minneapolis Meals on Wheels
PO Box 17210
Minneapolis, MN 55417
somplsmow@gmail.com
(612) 721-5487. Sara Larson, Coordinator
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If you are requesting Meals on Wheels delivery for yourself, fill in the following information.
What is your name?
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Your answer
What is your address?
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Your answer
What is your phone number?
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Your answer
What is your birthdate?
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If you are requesting Meals on Wheels delivery for another person, fill in the above information AND the information below.
What is your name?
Your answer
What is your phone number?
Your answer
What is your email address?
Your answer
What is your relationship to the person who wants Meals on Wheels delivery?
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