“Cousin It” Adams
This presentation is the property of its rightful owner.
Sponsored Links
1 / 99

“Cousin It” Adams 1313 Mockingbird Way Tulelake, CA 96134 PowerPoint PPT Presentation


  • 75 Views
  • Uploaded on
  • Presentation posted in: General

“Cousin It” Adams 1313 Mockingbird Way Tulelake, CA 96134. ADDRESS. AGE. APPLY HERE. APPLICATION. 4 /xx/xx. APRIL. 8 /xx/xx. AUGUST. AUTHORIZED PERSONNEL ONLY. CAUTION. CITY. Modoc. Siskiyou. Klamath. Josephine. COUNTY. DANGEROUS. 6/17/82. 10/7/05. 11/24/05. DATE.

Download Presentation

“Cousin It” Adams 1313 Mockingbird Way Tulelake, CA 96134

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


“Cousin It” Adams

1313 Mockingbird Way

Tulelake, CA 96134


ADDRESS


AGE


APPLY HERE


APPLICATION


4/xx/xx


APRIL


8/xx/xx


AUGUST


AUTHORIZED PERSONNEL ONLY


CAUTION


CITY


Modoc

Siskiyou

Klamath

Josephine


COUNTY


DANGEROUS


6/17/82

10/7/05

11/24/05


DATE


D.O.B. ______________

5/15/1992


DATE OF BIRTH


1-5-2006


DAY


12/xx/xx


DECEMBER


EMPLOYEES ONLY


$

BOSS


EMPLOYER


2/xx/xx


FEBRUARY


FIRST


FRIDAY


1/xx/xx


JANUARY


7/xx/xx


JULY


6/xx/xx


JUNE


KEEP AREA CLEAN


12-31-2006


LAST


3/xx/xx


MARCH


5/xx/xx


MAY


MIDDLE


MONDAY


MONTH


Hello, my ___________

is Dracula.


NAME


11/xx/xx


NOVEMBER


10/xx/xx


OCTOBER


867-5309

348-3927


PHONE NUMBER


PRINT


REPORT

Name Johnny Bravo

Description of Accident

I fell and broke my arm.

___________________


REPORT ALL ACCIDENTS


SAFETY RULES


SATURDAY


9/xx/xx


SEPTEMBER


John Doe

X _________________________


SIGNATURE


123-45-6789


SOCIAL SECURITY NUMBER


WV

CA

AZ

OR

AK

WA

UT

NY

NV

NM

ID

VA

CO

MT


STATE


SUNDAY


THURSDAY


TUESDAY


USE EAR PROCTECTION


WATCH FOR TRUCKS


WEAR SAFETY GLASSES


WEDNESDAY


1492

1776

2005

1812

1991


YEAR


77831

96134

97601


ZIP CODE


  • Login