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-Part I of 2 <br /> <br />FOR BOAHD <br /> <br />BASE# <br />PP~ <br />FEE <br /> <br />CHECK <br />INITIALS <br />DATE <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />I <br /> <br /> bus ness Acldress ol ~ganiz~l~on - $1me! oe P. O ~x (Do not use ~ ~ess oi your g~bli~ ~gm) <br /> <br /> C.y ~p C~ Coun~ . ~ Da~ime ph~o numbar <br /> ~ame ol ~1 as~i~ o~r {~ol ~ your ~ m~ager) ' ' ~Be Day,mo ph~no numbor <br /> <br />~ applying fora ~A ar C pe~t, ~ m ~ ~d beg~ & cndag hou~ ofb~o occasm~: No more ~ ~ bingo ~c~lo~ ~y be conducted by your~ per weelc <br /> Day Be~E~g Hou~ Day ~~E~ Hou~ Day <br /> <br /> ~lo If bingo will not be conducted, check here ['~ . <br /> <br /> Name oJ bsmt~lilnn~int~whbr~ ga,'~bhng'w~l| be ~c~c~ucmd Su'eel Ac~l~er~ {ilo nol uso a post oflsco °ax num0ar) ' <br /> <br />Is the pren~r~s ICmal~ wilt~n~aly limits? l~ Yes r'"'l No If no, is wwnship r'--t c~ganized ~ unorganized ,~ unincx3rp~alod <br /> i ,~ 1i . ,/b. <br />C.¥ and Co. my w~f~i~m ~gl~g ~am~ses ~s Ioca~l OR To~ns~i~ and C.o~n~, w~e~ gambhr~ ~em~ses is k~camct i! ou~sicie o~ ci~/limia <br /> <br />Name and adcYess~lf <br /> <br />O~s your <br /> <br /> · a m~ ot ~ ~e (~ L~2) ~ ~ ~r ~ ~t ~e ~m. <br /> · e ~py of a s~ ot ~ a~r ~ ~m d~s, s~g what ~n is ~g I~d. <br /> <br />:": :':'""::'' ::: :-F.; <br /> <br />41 <br /> <br /> (che~k arm) <br />A ($400) Puli-tabs, tipbaaJ'd% paddklwheel,:, raffles, ~n~o <br /> <br />B ($250) Pull-mbs, ~, ~~ls, ~lfios <br /> <br />C ($~) ~ngo o~y <br /> <br /> <br />