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/ST/ZIP CODE PHONE NUMBER PLEASE LIST PHYSICAL DESCRIPTION OF APPLICANT: SEX DATE OF BIRTH HEIGHT HAIR/EYE COLORS DRIVERS LICENSE NUMBER/STATE ISSUED LIST OTHER COMMUNITIES THAT APPLICANT HAS WORKED AS A SOLICITOR IN THE PAST 12 MONTHS: PLEASE LIST THE NATURE OF GOODS OR MERCHANDISE TO BE SOLD OR OFFERED FOR SALE OR NATURE OF SERVICES TO BE FURNISHED: WILL APPLICANT DEMAND, ACCEPT, OR RECEIVE PAYMENT OR DEPOSIT OF MONEY PRIOR TO FINAL DELIVERY? NO YES IF YES, APPLICATION SHALL BE ACCOM.

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