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If you would like to purchase a Commemorative Coin for $30.00 each, please fill out the form below.

Price: $30.00
Name
Address

*The Commemorative Coin will be sent to the address above.
*Checks should be written out to The Iowa Society of Radiologic Technologists.

*Please mail your check to:

Darin Delker
6223 Hwy 63 South
Ottumwa, IA 52501