Home Phone. CIRCLE ONE: U.S. Citizen Resident Alien Social Security or Tax ID #: Non-Resident Alien Custodian/Trustee Tax ID #: CERTIFICATIONS
Home Phone. Cell Phone: Winter Phone: Emergency Phone: I declare my PERMANENT/ NON GREEN ACRE PARK RESIDENCE/ PRIMARY RESIDENCE to be: Street: City: Prov/State: Postal/Zip Code: Email Address: ▢ I would like to receive correspondence (invoice, campground contract, etc.) by Email: by Canada Post: ▢ TRAILER INFORMATION Make: Model: Year: Insurance Company Name: Policy No: I have read and understood the most recent "Site and Trailer Review" pertaining to campsite (Schedule C) Yes: ▢ No: ▢■ I have read and understood "Customer Orientation Brief" (for New Customers Only): Yes: ▢ No: ▢■ I have completed an "Equifax Credit Report Authorization Form" (for New Customers Only): Yes: ▢ No: ▢■ Check Form of Use: 10 Month Recreational Use ▢ 6 Month Full-time Recreational Use (greater than 90 days use) ▢ 6 Month Part-time Recreational Use (less than 90 days use) ▢ CAMPSITE The Owner rents to Camper campsite # at Green Acre Park. The contract of use of the Site by the Owner to the camper shall be in consideration subject to the following terms and conditions: A 12-month contract for a term commencing on the 1st day of November 2023, and expiring on the 31st day of October 2024. It is expressly acknowledged that there is no representation of assurance by the Owner to the Camper that this contract will be renewed annually, and absent any written agreement of renewal of this contract for any period, the Camper shall vacate the site at the end of the term. Campsite fees are based on duration of stay and are detailed on Schedule B, included in this contract. Equifax Credit Check will be done for all new Customers. The Park is closed from January fist to March fist, without water, sewer, road clearing, or other services and with NO overnight accommodation during this period of time. PARK RULES AND REGULATIONS: The Camper acknowledges that the Camper has read and understood the terms of this contract, has read the rules and regulations governing the operation of the Park and understands the terms of such rules and regulations (also found on website xxx.xxxxxxxxxxxxx.xxx). The Camper agrees to comply with such terms and regulations and any changes made during the term of this contract and to require the Camper's guests and visitors to comply also. CAMPER INITIALS Office Use: SD Paid ▢ Credit Check Approval ▢ Google Doc ▢ Hydro Reading ▢ QB ▢ Online Pmt ▢ Cheques ▢
Home Phone. Resource Specialist: Cell Phone: PROGRAM EXPECTATIONS • 100% attendance for maximum benefit, attendance not to fall below the minimum standard of 85%. • Achieve maximum performance by striving for A’s & B’s understanding that I must maintain a minimum of C. • Behave respectfully and responsibly as stated in the GCC Student Code of Conduct. As a Gateway to College (GtC) Student, I agree to the following: (Initials required by student and parent/guardian) I will comply with the Gateway to College Program policies and expectations listed above and according to the policies discussed in my First Year Experience class. I will be prepared for class, attend all classes, arrive on time, and stay through the end of the class each day/each term. I agree to comply with expectations as outlined in my course syllabus for each class. I will communicate with my Student Resource Specialist if I am having difficulty fulfilling the expectations of the program and/or achieving my goals so that we can problem solve & strategize together for greater success. I will be responsible for myself and for my success in this program. I understand that if I do not abide by the terms of this agreement the following may occur: I may: Be placed on a Success Contract Be monitored by Student Resource Specialist Be dropped from the program If I turn 21 while I am in the program, I understadn that I could only complete the terms for the school year I am enrolled in. I understand that if i make changes during the term that affect my eligibility criteria (i.e.. move out of district, re-enter public high school, etc. I would be immediately dropped from the program. I am aware that I have the privilege of participating in this Scholarship Based Program and I commit to do my best to follow the expectations outlined in this agreement throughout my experience at GCC.
Examples of Home Phone in a sentence
Paying customers who subscribe to EarthLink DSL and Home Phone service are counted as both a broadband subscriber and a voice subscriber.
Chase 65 Home Address Home Phone 96 High Ridge Road, West Hartford, CT 06117 860-233-4446 Occupation Employer Employer's Business Executive Chase Enterprises Financial Business Address Business Phone One Commercial Plaza, Hartford, CT 06103 860-549-1674 Citizen Of Agent's Relationship, If Any, To The Principal Agent's Account No. With PW (if any) USA XXXXXXX Agent's Investment Experience: (Years of Experience) Reason for Agency Options: 10 years Stock/Bonds: 10 years Commodities: 10 years /s/ David T.
SECONDARY BENEFICIARY: Secondary Beneficiary Name(s) Relationship Home Address Home Phone # Work Phone # Cell Phone # This Beneficiary Designation hereby revokes any prior Beneficiary Designation which may have been in effect.
EMPLOYEE’S SIGNATURE: Male Female Address: Zip Code: City: Starting Date: Home Phone: Date of Birth: Dept.: Clock No. Beneficiary: Relationship: Soc.
Home Phone 5.Driver License Number State ______|_________|___________________|_____________|_______________________|_____ 6.
More Definitions of Home Phone
Home Phone. Cell: Other: Fax: Email: Work Phone: Fax: Other: Comments: Referral and Commission Information Referral Brokerage ’SELLER referral: YOUR office to receive % of Realty Solutions Listing Commission Referral Brokerage ’BUYER referral: YOUR office to receive % of Realty Solutions Selling Commission Realty Solutions Executives ’SELLER referral: Realty Solutions to receive % of YOUR office Listing Commission Realty Solutions Executives ’BUYER referral: Realty Solutions to receive % of YOUR office Sellling Commission Acknowledgement Information Please sign and return a copy of this agreement. It will serve as your acknowledgement and agreement to the above referral and commission arrangement. If you have any questions, please contact the undersigned agent. Realty Solutions: Referral Brokerage: Agent Signature: Broker Signature: Agent Signature: Broker Signature: 753080181
Home Phone. Day Phone: Mobile: As the parent of this child, I: • agree to them participating in work experience at the host workplace, as per the information in Section 3. Y ☐ N ☐ • agree to the information on this form being provided to the host workplace. ☐ ☐ • give permission for my child to receive first aid in the case of minor injury. ☐ ☐ • give permission to the host workplace to arrange for an ambulance and/or appropriate emergency medical treatment in the case of injury. ☐ ☐ • acknowledge that the host workplace employees are not required to hold a current Working with Children Clearance Notice unless the host workplace or its employees are engaged in child related employment as defined by the Care and Protection of Children Act. ☐ ☐ • agree to arrange and meet the costs of transport to and from the host workplace. ☐ ☐ • give permission for my child’s image (photograph &/or video) to be taken and used by the host employer. ☐ ☐ • provide the following information about any medical condition, medication and/or other relevant information that may affect my child’s capacity to participate in work experience eg: asthma; colour-blind; allergies.
Home Phone. Fax: Mobile Phone: Email: The Owner IS IS NOT a Resident Owner. (Tick the appropriate box) Owner has checked the Contractor’s licence and history via QBCC’s Online Licence Search: Yes No NOTE: An Owner is a Resident Owner if he/she intends to live in the Works on completion or within 6 months after completion. Owner’s Authorised Representative (if any): Address: The Owner and the Contractor agree that the Contractor shall carry out the work described in this Contract for the Total Price it provides and upon its terms. This Contract includes: New Home Construction Contract Schedule, PC and PS Schedules and Forms 1 - 7, all dated November 2013; General Conditions of New Home Construction Contract dated November 2013; and Plans, specifications and any other contract documents described in Item 17 of this Contract Schedule. IMPORTANT NOTICE TO OWNER: ‘COOLING-OFF’ PERIOD Under the Domestic Building Contracts Act 2000 (the ‘DBC Act’) you may have the right to withdraw from this Contract during the cooling-off period of 5 business days commencing when you have received both a signed copy of this Contract and the Contract Information Statement. If you wish to withdraw under the ‘cooling-off’ provisions you must give the Contractor a signed written notice stating that you withdraw from the Contract under section 72 of the DBC Act (see Condition 1 of the General Conditions and Part 1 of the Contract Information Statement for more details).
Home Phone. Fax: Mobile Phone: Email: QBCC NEW HOME CONSTRUCTION CONTRACT – NOVEMBER 2013 Page 2 of 4 Item Subject Notes Particulars 1. BRIEF DESCRIPTION OF THE WORKS Insert description of what is to be built and attach and refer to plans and specifications e.g. construction of a new 2 storey home as per attached plans dated… & specifications dated… Site Address: SITE Real Property Description:
Home Phone. Email address: Emergency Concact (name and telephone number): As parent of guardian of my son/daughter, I do herby agree to allow my son/daughter to accompany the youth ministry/campus ministry group of their parish/school to the . I acknowledge receipt of the attached information sheet describing the planned activity. In Consideration of the opportunity for my son/daughter to participate, I/we, as pare in the activity, the receipt and sufficiency of which are acknowledged, I knowlingly and voluntarily on behalf of myself and my child do hereby agree to forever RELEASE, HOLD HARMLESS AND INDEMNIFY: St. Xxxx the Evangelist, Xxxxx, St. Mark, Fallston, St. Stephen, Xxxxxxxx, St. Xxxx, Pylesville, St. Xxxxxxxx, XxxXxx, St. Xxxxxxxx, Xxxxxxx, Xx. Xxxxxxx xx Sales, Abingdon, Prince of Peace, Edgewood, Holy Spirit, Joppatown, St. Xxxx of Arc, Aberdeen, St. Xxxxxxx, Have de Grace , Roman Catholic Archbishop of Baltimore and his successors, a corporation sole, and their directors, officers, agents and employees from liability, claims, demands, actions and causes of action arising out of or relating to any loss, damage or injury sustained in connection with my son/daughter’s participating in this activity. I hereby grant permission to the group’s adult advisor in charge, to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that I cannot be reached. * I am covered by hospitalization and medical insurance under policy # . issued by * I do not have medical coverage and assume responsibility for the cost of hospitalization and medical care for my son/daughter. I hereby grant permission to any staff person to provide the following over-the-counter drugs to my son/daughter if requested by my son/daughter. (Circle all that apply.) Tylenol Benadryl Advil Sudafed Midol Immodium Neosporin ADD any other information concerning medication, allergies, illness, etc. ADD any dietary restrictions: Parents/guardians of participants are advised that photographs or videotapes of participants may be used in publications, websites, or other materials produced from time to time by the Youth Ministry Office. (Participants would not be identified, however, without written consent.) Parents/guardians who do not wish their child(ren) to be photographed or filmed should so notify the Youth Ministry Office in writing. Please note the Youth Ministry Office has no control over the use of photographs or film taken by media that may be cover...
Home Phone. Cell Phone: E-Mail Address: Will puppy be picked up or shipped to your airport? Shipped / Picked up (Circle one) Airport being shipped to: 1st Choice 2nd Choice Sex of Puppy: Male / Female (Circle one) Purchase Price: $ Shipping (puppy): $425.00 This is a legally binding contract with the purpose of protecting the Seller, Buyer and the puppy/ dog. Should you, the buyer, at any time prior to taking possession of your puppy should change your mind it shall be understood that any deposit paid is non refundable. As breeders, it is our hope that you will take exceptional care of this puppy throughout its entire life. This means providing socialization, medical, proper nutritional, physical needs as necessary, treating your dog as part of your family, and giving it lots of love for the remainder of its life. If for any reason you are unable to keep this puppy please contact us first. We will accept one of our offspring back. We do not repurchase or "buy back" dogs unless under the terms of our "right to first refusal" clause contained xxxxx. Remember that environment and how it raised has tremendous impact on how the dog will turn out. It is important that all Rottweilers get obedience training at an early age. Seller certifies that said puppy is in good health to the best of Seller’s knowledge. Buyer has 72 hours after purchase to take puppy to a veterinarian. If upon examination the veterinarian finds that said puppy is not in good health, the Buyer must notify the Seller within 24 hours. Buyer shall return the puppy to the Seller with all of the veterinarian documentation. Seller shall replace said puppy with another puppy of equal value as soon as one is available. The Buyer agrees that any and all transportation at any and all times, to and/or from the Seller’s premises, will be at the cost and sole responsibility of the Buyer. The seller is not responsible for any veterinary fees once dog/puppy has left sellers premises. No reimbursements for veterinary care will be made by seller to buyer. The Buyer agrees to have said puppy/dog micro-chipped and the chip id number shall be provided to Seller by registered mail within 60 days of purchase. The Buyer agrees to maintain preventative health care of the puppy including, but not limited to: supplemental folic acid, supplemental calcium and potassium (plain yogurt given daily is recommended) inoculations, internal as well as external parasites, heart worm preventative medication. The Buyer agrees to maintain pre...
Home Phone. Cell Phone: Social Security #: Guarantor’s Employer: Driver’s License #: Address: City: State: ZIP: Phone: