I will sell papers on December 2, 2011 and am available to sell at the following time:____________________________

I wish to sell papers in:
____North Toledo ____Sylvania
____South Toledo ____Oregon
____West Toledo ____Maumee
____East Toledo ____Perrysburg
____Point Place ____Rossford
____Wood County ____Waterville

Specific location I wish to sell papers ________________

If you normally worked a Kroger store, we are no longer able to do this per corporate policy. We will find you a suitable home. Please mention above the Kroger store you are normally responsible for.

Name: _________________________________________
Address:________________________________________
City:______________State___________Zip___________
Phone:________(HM)________(Cell)__________(Work)
Email: _________________________________________

Please return completed form to:

David Hendricks

3351 Hazelton

Oregon, OH 43616

Phone (419) 345-3893

Email: hendricks.david@det.sysco.com or daveh@bex.net

Please feel free to e-mail me this info as time is short