Total Please Renew / Begin my LDHS Century Club Membership ($150) Additional reserved season tickets ($36 each) Please add the Touchdown Tailgate Zone to my membership ($50) Total Please send this form along with payment to:
Laurens District 55 High School Century Club Attn: Jim Iacuone 5058 Highway 76 West Laurens, SC 29360
Please make checks payable to LDHS Athletic Booster Club
CCN: Parking #1: Sec.: Sec.: Sec.:
C C C
D D D
Century Club Use Only TTZ: Parking #2: Row: Seats: Row: Seats: Row: Seats:
Equipment â Replace the aging server that supports our website. Southern California. Genealogical Society &. Family Research Library. 417 Irving Drive.
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Please call Colby Meehan if you have any questions. Complete and sign the form ... Organization (if applicable). Name of Youth Worker Contact. Phone Number ...
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I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue. Service (IRS) ...
... or found on the Zachary Lane Elementary website. beginning 10/17/2017 (Click on the For Parents tab, then click on the Century Book Club in the drop down ...
Please ensure that copies of all registration forms accompany this entry form. Ensure that your Amateur Status form / Novice Status form is on file with NAPHA prior to the show, if applicable. Mail completed package to Show Secretary per show premium
Miles driven for charitable purposes. Donations to charity (noncash). Long-term care premiums (your spouse). If noncash donations are greater than $500, ...
meals and refreshments - so no more issues with damaged and lost cards. â purchase ... Title Mr Mrs Ms Miss Other............................ ... Download Permission.
You may cancel membership in this. program at any time with no obligation. to purchase titles currently saved for. you,. 9. Membership benefits require that you. keep your account in good standing by. picking up your comics regularly and/. or updatin
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Have you had a bone or joint injury that required x-rays, MRI, CT. surgery ... unexplained car accident, or sudden infant death syndrome)?. 25. ... Use a number from 0 (none) â 10 (severe) ______ ... PPE Form Club Sports 2015.pdf.
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