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 Team Member Application LOLA #9                                        LIGHT OF LOVE AMERICA #9 (English)                        Team Member Application  January 8-11, 2012      NAME: _________________________________________   BIRTHDAY: ___________________ GENDER: M / F                            Last                            First                                                 MM/DD/YYYY              MARITAL STATUS:   SINGLE:              MARRIED:              ADDRESS__________________________________________________________________________________     PHONE: Home ____________________________  Cell Number:____________________________________          Email Address:______________________________________________________________________________     CHURCH AFFILIATION: _______________________________________________________________________       _____________________________________________                                  ______________________________     TEAM MEMBER SIGNATURE                                                                                    DATE        If you have any questions, please contact     Janet Shin 718 644 0110 This e-mail address is being protected from spambots. You need JavaScript enabled to view it or     Daniel Chung 917 502 9313 This e-mail address is being protected from spambots. You need JavaScript enabled to view it   Â
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