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SAMPLE FORM 709 FOR 2012



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Llasc Order Form 2012 2013
  • Size: 185 KB
  • Author: none
  • Created: Tue Jan 8 00:56:29 2013
  • Total Pages: 1

Lincoln Lakes Area Snowmobile Club Order Form 2012-2013 Lincoln Lakes Area Snowmobile ClubLogo Wear Order Form 2012 2013Item Price Color Size Quantity Total PriceChoiceBaseball Hats 12 00White Black or Royal BlueJacket black with charcoal Grey lining 54 00L S Mock Shirt 17 00White Black or Royal BlueS S T-Shirt 10 50White Black or Royal BlueL S T-Shirt White Black or Royal Blue 13 50S S Polo T-Shi...

llasc.org/files/2014/09/LLASC-Order-For...m-2012-2013.pdf
Casa Membership Renewal Form 2012
  • Size: 89 KB
  • Author: none
  • Created: Tue May 17 21:33:05 2011
  • Total Pages: 1

Microsoft Word - CASA RENEWAL Form 2012.doc MEMBERSHIP RENEWAL Form 2011-2012 MEMBERSHIP RENEWAL Form 2011-2012Renewal of CASA membership is due by March 31st and must be Renewal of CASA membership is due by March 31st and must beaccompanied by a payment of 35 00 Please make your check payable to accompanied by a payment of 35 00 Please make your check payable toCASA CASAPlease print your informat...

casaaz.org/forms/CASA Membership Renewa...l Form 2012.pdf
Blank Enrolment Form 2012 13
  • Size: 29 KB
  • Author: none
  • Created: Fri Sep 7 22:30:41 2012
  • Total Pages: 2

Blank Enrolment Form 2012-13 Dark Peak Music CentreRegistration Form 2012-13Name of PlayerDark Peak Youth Orchestra Tuesday 7-8 30pm GlossopdaleDark Peak Concert Band Friday 5 30-7 30pm Bradbury HouseEnsembleGlossop Intermediate Wind Band Monday 5-6pm Bradbury HousePlease tick next to the ensemble s you arejoiningThursday 4 45-5 45pm Chapel PrimaryChapel Junior Wind BandSchool from 18th OctGlossop...

darkpeakmusic.co.uk/forms/Blank Enrolment Form 2012-13....orm 2012-13.pdf
Tuition Reimbursement Form 2012
  • Size: 24 KB
  • Author: none
  • Created: Thu Jan 26 13:08:51 2012
  • Total Pages: 1

Microsoft Word - Tuition Reimbursement Form 2012 Tuition Reimbursement FormUS EMEA Employees OnlyAccelrys goal is to develop the skills and knowledge resident within the organization and to support the careerdevelopment endeavors of our employees As such we encourage ongoing education and professional developmentand offer each eligible employee the opportunity to apply For tuition reimbursement be...

accelrys.gethrinfo.net/Portals/133/NEW/Tuition Reimburs...t Form 2012.pdf
Boat Rack Form 2012
  • Size: 137 KB
  • Author: none
  • Created: Fri Mar 16 11:43:12 2012
  • Total Pages: 1

Microsoft Word - Boat Rack Form 2012 BOAT RACK NON MEMBER 2012 2013REGISTRATION NUMBER SURNAMEINITIALS NAME BY WHICH CALLEDOCCUPATION ID NUMBER ADDRESS MALE FEMALECLUB DATE OF BIRTHRE REGISTRATION NEW MEMBERTELEPHONE H TELEPHONE WFAX CELL PHONEE MAIL important as all correspondence is through e mail SIGNATURE SIGNATURE OF MINOR S PARENT CLUB OFFICIAL AS WITNESS DATETHE FOLLOWING FEES MUST ACCOMP...

natalcc.co.za/docs/Boat Rac...k Form 2012.pdf
Aha Registration Form 2012
  • Size: 42 KB
  • Author: none
  • Created: Wed Apr 11 08:16:10 2012
  • Total Pages: 2

Microsoft Word - AHA Registration Form 2012 2012ALDERMAN HISTORICAL ASSOCIATION REUNIONREGISTRATION FORMIt s time again For descendants of Daniel Abigail Harris Alderman to meet at EvergreenBaptist Church Hinson Hall at Delway North Carolina We will come together at 12 noon onSaturday June 23 2012 and visit with one another until we have our meal at 1 00pm Ourmeeting will follow after we have eate...

aldermanhistoricalassociation.org/Alderman/Home_files/A...n Form 2012.pdf
Proxy Form 2012
  • Size: 25 KB
  • Author: none
  • Created: Fri May 4 15:18:12 2012
  • Total Pages: 1

Microsoft Word - Proxy Form 2012.doc Form OF PROXYANNUAL GENERAL MEETING OF ITSMF INCMAY 23 2012The undersigned being a voting member of itSMF Canada hereby appoints or failingthe individual named or if no individual is named the Chair of the Meeting as myproxy to act generally at the meeting on my behalf and to vote in accordance with the following directions at theAnnual General to be held on ...

itsmf.ca/images/fck/Image/Prox...y Form 2012.pdf
Membership Form 2012
  • Size: 121 KB
  • Author: none
  • Created: Fri Apr 27 13:08:35 2012
  • Total Pages: 1

FINAL MEMBERSHIP Form 2012.pub CLARA BARTON BIRTHPLACE MUSEUM ANNUAL 2012 MEMBERSHIPMuseum membership offers you an opportunity to learn aboutthe founder of the American Red Cross through toursvolunteer activities and educational programs Yourmembership dues support ongoing preservation andcare of the historic home and its collectionsBasic Member BenefitsComplimentary admission For regular toursAd...

clarabartonbirthplace.org/site/sites/default/files/MEMB...P FORM 2012.pdf
Bbnt Registration Form 2012 2013
  • Size: 101 KB
  • Author: none
  • Created: Wed May 30 22:06:33 2012
  • Total Pages: 6

Microsoft Word - BBNT Reg Form 2012-2013 BOGUS BASIN NORDIC TEAM2012- 2013 Registration FormOne Form per athleteAthlete s Name Birth Date Age Athlete Cell Phone Athlete E-mail School Name Grade Fall 2012 13Nordic skiing background For winter programsPrograms please check oneSelection Team Cost PaymentAmountCompetition Team 9th-12th GradeFull Year 5-6 days week May 1 March 31 2 650 00 Summer 5-...

bbnt2.weebly.com/uploads/1/6/0/4/16047266/bbnt-registra...m-2012-2013.pdf
Test Form 2012
  • Size: 77 KB
  • Author: none
  • Created: Wed Feb 22 22:13:00 2012
  • Total Pages: 1

Microsoft Word - Test Form 2012 NZIFSANEW ZEALAND ICE FIGURE SKATING ASSOCIATION INCFIGURE SKATING MEDAL TEST FORMAvondaleTC Number Test Date Full name Phone number Mobile Email Home Club Coach Test s Coach signature Date Club Secretary signature Date Amount Received Test Fees - Stroking or FreeMEDAL FEE ICE TIME TOTALElementary Preliminary 35 00 25 00 60 00Inter Bronze Silver 35 00 40 00 75 0...

nzifsa.org.nz/forms/Tes...t Form 2012.pdf
New Members Form 2012 2013
  • Size: 21 KB
  • Author: none
  • Created: Mon Jul 2 13:40:00 2012
  • Total Pages: 1

Microsoft Word - New Members Form 2012-2013.doc WOODFORD GLEN SPEEDWAYAPPLICATION Form For NEW MEMBERS 2012 2013Name Address SuburbTownPostal Code Phone Home MobileNote Please include a valid mobile number as we operate a free text service For club membersEmail Note Please provide an email address as we use email to help keep you informedDriver Yes No Occupation Class Preferred Racing Number Not...

woodfordglen.co.nz/20122013/New Members Form 2012-2013....m 2012-2013.pdf
3on3 Application Form 2012
  • Size: 89 KB
  • Author: none
  • Created: Mon Nov 7 10:48:46 2011
  • Total Pages: 4

3on3 Application Form 2012 Fat Kids 3on3 Streetball Championships 2012 Application FormIt is important to know that there are ONLY 16 spots available For this competitionand all spots are STRICTLY allocated on a first come first serve basis Applicationcloses January 06th 2012NOTE Please fill in all columns with accurate contact details to ensure easy communicationabout the 3on3 competition at any ...

iamfatterthanyou.com/blog/wp-content/uploads/2011/11/3o...n-form-2012.pdf
Spring Half Term Holiday Form 2012
  • Size: 89 KB
  • Author: none
  • Created: Mon Jan 9 00:04:48 2012
  • Total Pages: 1

Spring Half Term Holiday Form 2012 Worcester Tennis Academy Coaching Application FormIf you wish to apply For more than one course please photocopy this Form and send forms together to the address belowor alternatively please attach a piece of paper along with all the required information detailed below to this Form and sendto the address below If you would like an electronic email version of the ...

worcestertennis.co.uk/wp-content/uploads/2008/08/Spring...y-Form-2012.pdf
Gr 12 Selection Form 2012
  • Size: 74 KB
  • Author: none
  • Created: Wed Feb 29 12:53:18 2012
  • Total Pages: 1

Microsoft Word - Gr 12 selection Form 2012 Stelly s Secondary SchoolCOURSE SELECTION ENTERING GRADE 12StudentNameCurrent GradePLANNING For GRADUATIONAn information evening For parents of students entering Gr 12 at Stelly s will be held onMarch 7 2012 6 30 pmFor further information please see our website at http stellys sd63 bc caIMPORTANT NOTE Grade 11 required course must be completed before adva...

stellys.sd63.bc.ca/pluginfile.php/6371/mod_label/intro/...n form 2012.pdf
Guidebook Order Form 2012 2013
  • Size: 2359 KB
  • Author: none
  • Created: Thu Sep 29 14:20:24 2011
  • Total Pages: 1

Guidebook Order Form 2012-2013 Guidebook 2012-13 Order Form Full Page4 5 8 x 7 5 8Business Name Contact Person Half PageTelephone Fax Half Page Horizontal 4 5 8 x 3 3 4email Verticle2 1 4 x 7 5 8Renew Last Year s Ad with NO Changes Quarter PageRenew Last Year s Ad with these changes Horizontal 4 5 8 x 1 3 4Quarter PageVerticleNEW AD 2 1 4 x 3 3 4Eighth PageFULL PAGE QUARTER PAGE 2 1 4 x 1 3 44...

gatewaytomaine.org/wp-content/themes/wp-crossroad/img/g...m 2012-2013.pdf
Donation Form 2012
  • Size: 43 KB
  • Author: none
  • Created: Fri Sep 28 10:24:36 2012
  • Total Pages: 1

Microsoft Word - Donation Form 2012.doc National Association of Women in Construction Boise Chapter 24522nd Annual Awards Dinner and AuctionDONATION FORMDinner Live Auction will be held October 27 2012 at The Riverside Hotel BoisePlease submit Live Silent Auction donation forms by 10 24 12Online Auction Forms by 10 15 12Donated Item Retail ValueComplete Description Include all facts i e color size...

nawicboise.org/files/Donatio...n Form 2012.pdf
Cattle Display Letter With Form 2012
  • Size: 964 KB
  • Author: none
  • Created: Thu Mar 8 12:04:23 2012
  • Total Pages: 10

CATTLE DISPLAY LETTER WITH Form 2012 Patron Her Majesty The QueenChairman of Council Chief ExecutiveAlun Evans David WaltersC B E DL F R Ag S OBE B Sc Hons F R Ag SCYMDEITHAS AMAETHYDDOL FRENHINOL CYMRU CYFTHE ROYAL WELSH AGRICULTURAL SOCIETY LTDBWJ RMD 23rd February 2012Dear Sir Madam2012 Royal Welsh Spring Festival 19th 20th May Cattle Stand CompetitionWe have great pleasure in enclosing the 201...

rwslinux.hostinguk.com/assets/var/docs/spring/schedules...H-FORM-2012.pdf
Registration Form 2012
  • Size: 199 KB
  • Author: none
  • Created: Mon Apr 16 12:11:26 2012
  • Total Pages: 1

registration.Form.2012 Registration FormThere are four ways you can registerOnline at www lynneslegacyrun caIn person at Runner s Den in WestdaleComplete this Form detach and mail to address on reverseIn person on race dayName PhoneAddress EmailGender Male FemaleCity Age on race dayProvince Postal Code Birthdate mm dd yyREGISTRATION FEESRACE 5K Run 5K Walk 1K Kids Run5K Run Walk Includes shirt lun...

lynneslegacyrun.ca/images/registratio...n.form.2012.pdf
Directors Nomination Form 2012
  • Size: 62 KB
  • Author: none
  • Created: Tue Mar 13 10:25:27 2012
  • Total Pages: 1

Microsoft Word - Directors nomination Form 2012 2012 NOMINATION FORMELECTED DIRECTOR OF THE BOARDWEA ILLAWARRAI insert full nameOf residential addresshereby wish to nominate For the position of Director of the Board of the WEA IllawarraWorkers Educational Association Illawarra - ABN 14 062 944 950 For a two 2 year termI am aware that Director position s are voluntary with no remuneration payable...

weaillawarra.com.au/pdf/Directors nomination form 2012....n form 2012.pdf
Booking Form 2012
  • Size: 112 KB
  • Author: none
  • Created: Wed Jan 4 17:07:15 2012
  • Total Pages: 1

Booking-Form 2012.ai e Revel EndLittl Cat ter y Gr oomne ls ingKen Training Ceav io ur ntreBehLittle Revel End Kennels and Cattery Little Revel End RedbournHerts AL3 7AJBooking Form 2012T 01582 794862E littlerevelendkennels hotmail comW www littlerevelend comName of animal s to be boarded Dog Cat please deleteBreedBreedBreedWould you like your dog bathed or fully groomed Please indicateIf more tha...

littlerevelend.com/docs/Bookin...g-Form-2012.pdf
Field Trip Form 2012 2013
  • Size: 36 KB
  • Author: none
  • Created: Fri Jan 4 07:22:36 2013
  • Total Pages: 2

Microsoft Word - Field Trip Form 2012 - 2013.doc CANON-MCMILLAN SCHOOL DISTRICTEDUCATIONAL FIELD TRIPSubmit ONE COPY to your principal 2 weeks before actual date of Field TripBuilding Date Submitted1 Teachers Planning Trip Subject Grade2 Destination Destination in excess of 35 miles must be approved by the Superintendent3 Educational Objectives Be Specific-Describe Curriculum Outcomes4 State Stand...

cmsd.k12.pa.us/cmsd/cm_main/Field Trip Form 2012 - 2013...2012 - 2013.pdf
Membership Form 2012
  • Size: 4239 KB
  • Author: none
  • Created: Thu Nov 10 04:09:28 2011
  • Total Pages: 1

Microsoft Word - Membership Form 2012.docx Northern Territory Membership Form2012NEW MEMBER q RENEWAL Member NoName s1st Person 2nd Person If you are joining as a household you are entitled to two memberships cards please provide two namesPostal Address State Postcode Phone Fax Mobile Email Type of membership please tick box Please Note1 Year 3 Years No joining fee required if renewingIndividu...

nationaltrustnt.com.au/files/Membershi...p-Form-2012.pdf
Lincoln Trail Hike & Pilgrimage Event Participation Form 2012
  • Size: 84 KB
  • Author: none
  • Created: Tue Apr 3 09:30:44 2012
  • Total Pages: 1

Microsoft Word - Lincoln Trail Hike & Pilgrimage Event Participation Form 2012.doc BSA Troop 48 Event Participation Commitment FormScout Name Phone Number Event Lincoln Trail Hike Pilgrimage Event Date s April 28 29 2012Location New Salem Petersburg April 28 Springfield April 29 Departure Details 6 15 am April 28 depart from Chatham Presbyterian Church10 30 am April 29 meet at north east corner o...

troop48chatham.com/\Forms_Files\Lincoln Trail Hike & Pi...n Form 2012.pdf
Registration Transfer Form 2012
  • Size: 416 KB
  • Author: none
  • Created: Wed Aug 1 10:58:33 2012
  • Total Pages: 1

Registration Transfer Form 2012 Registration Transfer Form2012 Richard S Caliguiri City of Pittsburgh Great RaceTRANSFER INSTRUCTIONSOriginal Runner 1 Print this form2 Fill out and sign the form3 Give it to the runner who will be replacing you along with your bib if already picked upNew Runner 1 Look up the number of the runner you are replacing pick up the bib and bring it with thisform to the Pr...

rungreatrace.com/pdf/Registration Transfer Form 2012.pd...r Form 2012.pdf
Budget Form 2012 Web
  • Size: 170 KB
  • Author: none
  • Created: Mon Aug 13 12:47:55 2012
  • Total Pages: 2

Microsoft Word - Budget Form 2012 web Family Owned Operated Since 1950 ACT NOW17R Boston Post RoadPO Box 299Waterford CT 06385Capped Smart Pay Limited GallonsWhen Gallons are SoldBudget 2012-2013860 443-6115Program is Closedoffice benvenutioil comSeptember 5th or SoonerCT License 306827CT HOD 243Benvenuti Oil is pleased to offer to our customers a choice of Smart Pay Budget or Capped Smart Pay Bud...

bvo.towfowi.net/wp-content/uploads/2012/08/Budget-Form-...rm-2012-web.pdf
Jury Submission Form 2012
  • Size: 50 KB
  • Author: none
  • Created: Tue Jun 19 11:17:22 2012
  • Total Pages: 1

Jury Submission Form 2012 Washington Street Artists CooperativeJury Submission FormPlease bring this completed Form along with three 3 to five 5 samples of yourwork to the Gallery located at 108 N George Street Charles Town West Virginiaduring the times announced For jury submission see website Also include abiography and a short artist s statementYou will receive a receipt For your work and a sch...

wstreetgallery.files.wordpress.com/2010/07/jury-submiss...n-form-2012.pdf
School Group Visit Reservation Form 2012 A
  • Size: 86 KB
  • Author: none
  • Created: Wed Jan 4 11:01:36 2012
  • Total Pages: 3

Microsoft Word - School Group Visit Reservation Form 2012 DB edits School Group Visit Reservation FormFor more information please visit rmanyc org schoolprogramsSchool Organization Name NYCDOE School Yes NoSchool Organization AddressName PhonePrimary GroupContact PersonEmail Cell phone on day of visitNumber of students Grade level of studentsNumber of chaperones Will you arriving by school bus Yes...

rubinmuseum.org/uploads/documents/School Group Visit Re...Form 2012 A.pdf
Health History Form 2012 Cf
  • Size: 132 KB
  • Author: none
  • Created: Wed May 16 04:26:16 2012
  • Total Pages: 1

Health History Form 2012.xls EAU Pg 5 of 6HEALTH HISTORY FORMCamper Name Camper Birthday AgePlease list any hospitalizations serious or unusual illnesses the staff should be aware of Please list any behavioral or emotional problems you feel the staff should knowDate of Last Seizure Frequency of Seizures -Action to take if your child has a seizure at camp ie call 911 call you PRN medications et...

epilepsyut.org/downloads/Health History Form 2012 CF.pd...orm 2012 CF.pdf
Participant Release Form 2012
  • Size: 18 KB
  • Author: none
  • Created: Fri Apr 13 18:07:06 2012
  • Total Pages: 1

Microsoft Word - Participant Release Form 2012 Exhibit C Participant Release Form 2012COMPLETE ALL SECTIONS PLEASE PRINT OR TYPEFirst Name MI Last NameStreet Address AptCity State ZipHome Phone Alternate Phone EmailDo you have arthritis Yes No If yes what typeI understand and agree that there are risks both foreseeable and unpredictable associated with any exercise oreducation program I am aware o...

health-fitnesscenters.com/lakeforest/group_exercise/Par...e Form 2012.pdf
Submission Form 2012
  • Size: 13 KB
  • Author: none
  • Created: Mon May 21 09:16:21 2012
  • Total Pages: 1

Microsoft Word - Submission Form 2012 Fungicide Sensitivity of Apple Scab 2012- Cornell UniversityNo samples will be accepted after Friday July 6 2012Send Leaves to Sara VillaniNew York State Agricultural Experiment StationDepartment of Plant Pathology and Plant-Microbe Biology 218 Barton Laboratory630 West North StreetGeneva NY 14456Telephone 315-787-2401 e-mail smv8 cornell edu or kdc33 cornell ...

fruit.cornell.edu/tfabp/smor/Submissio...n form 2012.pdf