2005 FALL/WINTER LEAGUE APPLICATION      

Individual           Couple            Team

Name ___________________________________________

Address _________________________________________

City _______________________ State ______  Zip _______

Telephone ________________________________________

League Choice ____________________________________

Other Team Members _______________________________

_________________________________________________

_________________________________________________

Print out this form and mail to:  Faxon Lanes
                                                    Attn: Debbie     Vincenzes
                                                    1225 River Avenue
                                                    Williamsport, Pa. 17701

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