%PDF-1.7
%
1 0 obj
<>
endobj
2 0 obj
<>stream
2016-01-13T13:31:37-07:00
2016-01-13T13:31:37-07:00
2016-01-13T13:31:37-07:00
Adobe Illustrator CC 2015 (Macintosh)
256
36
JPEG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GLT
SRC PT INTAKE FORM 160113
xmp.did:72b38239-56b3-477e-bc46-ec3e5768bf54
uuid:e31325f4-497b-d04d-bde5-9b0252e92bbb
uuid:9c14dea5-1ddc-4b30-a7aa-6bf5963f60ee
proof:pdf
uuid:87d15210-4a5d-bb49-8f1a-8e831794165f
xmp.did:7231be33-d6d2-402f-aae0-71811be6ae93
uuid:9c14dea5-1ddc-4b30-a7aa-6bf5963f60ee
proof:pdf
saved
xmp.iid:ccd1462f-6a69-43b7-87aa-24e1ce0ae524
2015-12-11T12:48:57-07:00
Adobe Illustrator CC 2015 (Macintosh)
/
saved
xmp.iid:72b38239-56b3-477e-bc46-ec3e5768bf54
2016-01-13T13:31:24-07:00
Adobe Illustrator CC 2015 (Macintosh)
/
Adobe PDF library 15.00
1
False
False
8.500000
11.000000
Inches
Cyan
Magenta
Yellow
Black
Default Swatch Group
0
endstream
endobj
3 0 obj
<>
endobj
5 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
6 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
7 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
8 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
9 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
10 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
11 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
12 0 obj
<>>>/TrimBox[0.0 0.0 612.0 792.0]/Type/Page>>
endobj
21 0 obj
<>stream
HWY+)xk_No> !Y9dPD.9,+Ȩ_og6=lm_ǿ_~{_2۽)[w[B4Q(Ml9Bt2,[e1Vl01.bDq&CO@QWs)ҳ N9p &-}yKr1@@B͂pX[Q(R+pGSFe9OEyM1qsaUڔEEXDy+ypSr)|=d L&DBrLDVk[(7acJoX=n>oǯh أ,&g16Wrt#N^]]'%I$t`/q&atmkMAJvl DBCjxn!N3⊿\o
WJc֧S|36`GCp 2r7rbPkEԡL.&4A]#˙V) “VdA9RZL fZ)|/[QŭEm(b0)1.kN]CڧگJv
c5V1ꆠp] + |F*,ZIxA[j"p9_Ч;flHxfaش{t
h$+P/xmAn
9ug)tbXrʚYbf0ApfkH)0<'0SYT(
T6.]+BM'
Z= L@cBlZS
b]*Z@+grA.6P+)3l_s
ծA/R"E2Ő٠TT/DIuV2 K<;D0luJ]sB'Hw^!΅pz,\Z_T2Tq7oܑSNa#zRĘyGj2J"Jd;mHAcu0z)6|5Y\* $mG00M+2RnI&F+ܑ|7[p9R.#ix'giҕf1NnA5U!zSHrpq0i4e(ZTޅM{Ƶ<"=+D4c$"Rzt}b&&h0 x'Q?;RP!\ }P, $c] )OSm5}3[-^m!@A5$^*\W7q*Uvrǣ@mu~Ԓ ROJ}C- 澢"*hh`!Q+_W [Sy#VφZ5X:6V
I0KCK?+kNPݥEld>dCU;N!{}Cn>Ɍv$RY_MKޗ"*-cumz#J U>
!I=eT)\C'| Ar!]GZ
E+ʹ("KOǙ-