Recipient Name definition

Recipient Name. Position: Address: Telephone: Email:

Recipient Name. [Recipient Name] Signature: Date: [Date]

Recipient Name. ACN: Address: (the Recipient) Contact details of primary contact of the Recipient Name: Position: Email: Telephone Number:

Examples of Recipient Name in a sentence

• Los Angeles Unified School District Recipient Name [ADDRESS] Recipient Address 000 Xxxxx Xxxxxxx Xxxxxx Los Angeles, California 90017 Signature Print Name Signature Print Name Title Date State and federal laws strictly regulate the protection of students’ educational record information.

• Recipient Name: ........................................................................

• Prior to beginning the work authorized herein, [Recipient Name] shall provide the NPS with confirmation of such insurance coverage.

• Signing Party, the Recipient Name: ..............................

• Purchase Order Number Billing Address Invoice Recipient Name Invoice Recipient Email Invoice Recipient Tel.

• AcknowledgementEnter the participant’s first and last name.Recipient or Representative SignatureRecipient’s Signature – Must match Recipient Name.

• This Loan is made to the [Insert Recipient Name] (“Borrower”) for an energy savings Project.

• Recipient (Name of National Competent Authority NCA)Address of National Competent AuthorityDate of this reportReference number assigned by the manufacturerReference number assigned by NCAType of report Trend Initial Trend Follow up Trend FinalDo these incidents / trend represent a serious public health threat?Yes NoIdentify to what other NCAs this report was also sent2.

• JQA Application for Testing / Certification Services ＜Shipping Address for Test Reports & Certificates＞Same as “Applicant Inf.” Same as “Contact Person's Inf." As Follows Company Name Address Recipient Name Department, Job title *If this list is not provided, or the list is provided as a blank sheet, we will send the document(s) to the person as per ‘JQA Application for Testing /Certification Services 2.

• Recipient Name: Provide the Name of the Recipient (i.e. Town/Village/City/County of Name of Community.Project #: Enter the Office of Community Renewal assigned project number.

More Definitions of Recipient Name

Recipient Name. Address: Email: Telephone: Provider Name: Address: Email: Telephone: How will the material be used Please attach a copy of documentation indicating ethical approval for tissue use, or, indicate why ethical approval is not needed.

Recipient Name. Address: Email: Telephone: Provider Name: Address: Email: Telephone: How will the material be used: Please attach a copy of documentation indicating ethical approval for use, or indicate why ethical approval is not needed.

Recipient Name. Address: Email: Telephone: Provider Name: Xxxx. X.X. Xxxx Address: Manchester Brain Bank, Salford Royal NHS Foundation Trust, Clinical Sciences Building, Xxxxx Xxxx, Salford, M6 8HD Email: xxxxx.x.xxxx@xxxxxxxxxx.xx.xx Telephone: +00 (0)000 000 0000 How will the material be used Please attach a copy of documentation indicating ethical approval for tissue use, or, indicate why ethical approval is not needed.

Recipient Name. Attention: Address:

Recipient Name. County of Xxxxx Xxxxx Number: CA1552L9T071802 Tax ID Number: 00-0000000 DUNS Number: 000000000

Recipient Name. DOB: ______________ Age: __________________ Height: __________________________________________ Weight: __________________________________________ Primary Diagnosis: __________________________________________________________________________________ Secondary Diagnosis: _______________________________________________________________________________ Indicate the daily frequency of each of the above medical issues: _____________________________________________ __________________________________________________________________________________________________ Additional medical information we should be aware of/medical intervention required: ___________________________ _________________________________________________________________________________________________ Level of support receiving medication (Circle One): Supervision Assistance Total Support List Other: ____ Has your child experienced any serious illnesses? _________________________________________________________ Which best describes the service recipient’s hearing (with hearing aid if used): Circle one Normal Mild Loss Moderate loss Severe loss Profound loss Undetermined Which best describes the service recipient’s vision (with glasses or contact lenses if used): Circle one Normal Moderately impaired Severely impaired Light perceptions Total blindness Undetermined Allergies (Food/Drugs/Environmental): __________________________________________________________________ If so, what is their symptoms and treatment when exposed: _________________________________________________ Communication Skills (Circle only one): Verbal Limited Verbal Non-Verbal Circle all that apply: Communication Device Sign Language Communication Board Other ___________________ Makes sounds or gestures to get the attention of others Yes No Communicates basic needs speaking or signing Yes No Communicates wants and needs Yes No Responds when name is called by looking at person speaking Yes No Indicates “yes” or “no” in response to simple question Yes No Ability to read and write Yes No Answers and is able to use the telephone to contact others Yes No Responds appropriately to most common signs or symbols Yes No Understands the meaning of “no” Yes No Understands one-step directions Yes No Understands two-steps directions Yes No Understands a joke or story Yes No Asks simple questions Yes No Relates experiences when asked Yes No Describes realistic plans in detail Yes No Eats independently? Yes No Diet Restrictions: __________________...