MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C9741A.CB0194E0" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Windows® Internet Explorer®. ------=_NextPart_01C9741A.CB0194E0 Content-Location: file:///C:/2B8BDD12/rutter.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii"

rutter’s martial arts

        =   6634 Stones Dairy Rd. Bassett, VA 24055

        =   (276) 629-3412 or (276) 340-3944

        =   Scottrutter1@hotmail.com=

 

Membership Application

 

Applicant Information

Last Name

 

First

 

M.I.

DOB

 

Street Address

 

Apartment/Unit #

 

City

 

State

 

ZIP

 

Phone

 

E-mail Address

 

Cell Phone

 

Business Phone

 

Height, Weight

 

Occupation

 

 

Education

School

 

Address

 

From

 

To

 

Did you graduate?

YES  ------=_NextPart_01C9741A.CB0194E0 Content-Location: file:///C:/2B8BDD12/rutter_files/filelist.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" ------=_NextPart_01C9741A.CB0194E0--