Name*:______________________________________________________
Date:_______________________________________________________
Address*:___________________________________________________
____________________________________________________________
City/State/Zip*:____________________________________________
Phone:(____)__________________________________
E-Mail*:______________________________________

Send the video on a CD or VHS to the address below, you will then find your name on the web page to make sure your video has been recieved.

Los Medanos College
c/o RECCA Society
2700 E. Leland Rd.
Pittsburg, CA 94565