Purpose: instructions: use this form to document instructor and student attendance. type or print in ink. follow instructions for mailing and maintain a copy of the roster in the clinic files. if the student has an out-of-state driver's license,...
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Dix hills basketball association dix hills basketball association, inc. 92 field street west babylon, ny 11704 (631) -8475 fax: (631) -8552 .dixhillsbasketball.com official team roster form team name: town: sport (boys/girls): grade: level: a b c...
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Youth basketball league team roster form (parent / guardian signature must be included for every player) coach's name team name choose one: season (example: "fall 5on5 league," "spring 3on3 league") choose one: choose one: boys team 2nd grade 7th...
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Basketball roster form 2010 ayl basketball roster date 11/28/2010 club eagles grade 4th division div 1 conference boys team name green head coach chris harned club delegate (printed) eric holt club delegate signature eric holt vp signature kevin...
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Beechfield united football club registration form 2011-12 season team name: manager s name: player s details surname please affix forename recent player address including postcode photograph in this space date of birth gender male / female school...
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Carbon recreation adult sports roster form for office use only: amount receipt chk cash team league captain phone (h) (w) this roster form must be filled out completely and signed by each team member. each player accepts financial responsibility...
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Tpp class roster submittal order form. this form is to be filled out if you, as aprofessor, would like your students to order specific material from pearson for acourse you are teaching. once this form is submitted and approved your studentswill...
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Employer certification ohio highway patrol retirement system 6161 busch blvd., suite 119 ? columbus, oh 43229 .ohprs.org 614.431.0781 ? 800.860.2268 part i is to be completed by employee/hprs retiree, part ii is to be completed by employer. the...
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Fmd-200 (03/01/02) michigan state police mi fire fighters training council attendance roster course name subject assigned student number course number level student names (type or print) student signatures 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17...
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Jear'tr of ':j dixie truck brokers r.e. garrison trucking company .heartofdixie.4t.com toll free: 800-643-1128 fax: 256-734-7660 local: 256-737-1712 carrier packet please sign and return to fax 256-734-7660 with the following; your authority page...
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2016 team roster form team name: manager: division: email address: phone: home field: # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 player name primary team 2nd team 3rd team email (required) registration paper/online amount
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Ems report i date n c i inc d loc e n prov t i n f o b. contact protocol t r a n s 9 ama 9 code 3 mm/dd/y street number a/b/h inc # jur sta pd unit # 9 no pt 9 cx at scene 9 pub asst 9 doa 9 pronc'd by base 9 ift 9 pg 2 city code incident zip code...
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Application for licensure as a master social worker georgia state board of professional counselors, social workers, and marriage & family therapists 237 coliseum drive, macon, georgia 31217 phone (478) 207-2440 * .sos.state.ga.us/plb/counselors...
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The utilization threshold program the utilization threshold program 1. what is the ut program? the utilization threshold (ut) program places limits on the number of services a medicaid beneficiary may receive in a benefit year. a benefit year is a...
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