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\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{
\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13071497\charrsid8076455 
\par  8) Christian Education}{\f37\fs22\insrsid8613952  }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}
{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14559697 \tab }{
\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{
\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13071497\charrsid8076455 
\par }{\f37\fs22\insrsid13464057\charrsid8076455  9) Sunday School }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}
{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid8613952 \tab }{
\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{
\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13464057\charrsid8076455 
\par 10) CYF }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {
\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14559697 \tab }{\f37\fs22\insrsid6894661\charrsid8076455 1}{
\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{\f37\fs22\super\insrsid6894661\charrsid8076455 th}{
\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3200000000000000000000000000}
{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid2892203\charrsid8076455 
\par }{\f37\fs22\insrsid13464057\charrsid8076455 11) Young Adult}{\f37\fs22\insrsid8613952  }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}
{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14559697 \tab }{
\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{
\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13464057\charrsid8076455 
\par 12) Membership }{\f37\fs22\insrsid8076455\charrsid8076455 and}{\f37\fs22\insrsid13464057\charrsid8076455  Evangelism }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 
000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{
\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14559697 \tab }{\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {
\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{
\f37\fs22\insrsid6894661\charrsid8076455  4}{\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13464057\charrsid8076455 
\par 13) Lay Council }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt 
{\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14559697 \tab }{\f37\fs22\insrsid6894661\charrsid8076455 1}{
\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{\f37\fs22\super\insrsid6894661\charrsid8076455 th}{
\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3200000000000000000000000000}
{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13464057\charrsid8076455 
\par 14) Usher Board }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt 
{\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14559697 \tab }{\f37\fs22\insrsid6894661\charrsid8076455 1}{
\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{\f37\fs22\super\insrsid6894661\charrsid8076455 th}{
\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3200000000000000000000000000}
{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13464057\charrsid8076455 
\par 15) Pastor\rquote s Aid}{\f37\fs22\insrsid8076455\charrsid8076455  }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}
{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14559697 \tab }{
\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{
\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid13464057\charrsid8076455 
\par }{\f37\fs22\insrsid8076455\charrsid8076455 16) Choir(s): }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}
{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{
\f37\fs22\insrsid8076455\charrsid8076455  }{\f37\fs22\insrsid14559697 \tab }{\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {
\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{
\f37\fs22\insrsid6894661\charrsid8076455  4}{\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid8076455\charrsid8076455 
\par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\tx1530\tx8190\tx8640\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8613952 {\f37\fs22\insrsid8613952 \tab }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{
\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid8076455\charrsid8076455  }{\f37\fs22\insrsid14559697 \tab }{\f37\fs22\insrsid6894661\charrsid8076455 1}{\f37\fs22\super\insrsid6894661\charrsid8076455 st}{
\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3100000000000000000000000000}
{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{\f37\fs22\super\insrsid6894661\charrsid8076455 th}{\f37\fs22\insrsid6894661\charrsid8076455  }
{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}
\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid8076455 
\par }{\f37\fs22\insrsid8613952 \tab }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname 
Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14900186 \tab }{\f37\fs22\insrsid6894661\charrsid8076455 1}{
\f37\fs22\super\insrsid6894661\charrsid8076455 st}{\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 
650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid6894661\charrsid8076455  4}{\f37\fs22\super\insrsid6894661\charrsid8076455 th}{
\f37\fs22\insrsid6894661\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid6894661\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3200000000000000000000000000}
{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid14900186 
\par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\tx450\tx8190\tx8640\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid1319927 {\f37\fs22\insrsid14900186 17) Other Organizations:
\par }\pard \ql \li0\ri0\sl360\slmult1\widctlpar\tx450\tx4230\tx8190\tx8640\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid8613952 {\f37\fs22\insrsid14900186       Name }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{
\f37\fs22\ul\insrsid4869991 {\*\datafield 000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}{\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14900186  / }{\field\flddirty{\*\fldinst {\f37\fs22\ul\insrsid8613952  FORMTEXT }{\f37\fs22\ul\insrsid4869991 {\*\datafield 
000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\f37\fs22\ul\lang1024\langfe1024\noproof\insrsid8613952 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}{
\f37\fs22\ul\insrsid8613952 \tab }{\f37\fs22\insrsid14900186 \tab }{\f37\fs22\insrsid13400451\charrsid8076455 1}{\f37\fs22\super\insrsid13400451\charrsid8076455 st}{\f37\fs22\insrsid13400451\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {
\f37\insrsid13400451\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 {\*\datafield 650000001400000006436865636b3100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check1}\ffdefres0}}}}{\fldrslt }}{
\f37\fs22\insrsid13400451\charrsid8076455  4}{\f37\fs22\super\insrsid13400451\charrsid8076455 th}{\f37\fs22\insrsid13400451\charrsid8076455  }{\field\flddirty\fldpriv{\*\fldinst {\f37\insrsid13400451\charrsid6894661  FORMCHECKBOX }{\f37\insrsid4869991 
{\*\datafield 650000001400000006436865636b3200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check2}\ffdefres0}}}}{\fldrslt }}{\f37\fs22\insrsid14900186 
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