%PDF-1.5 % 63 0 obj <> endobj xref 63 183 0000000016 00000 n 0000004053 00000 n 0000004962 00000 n 0000005026 00000 n 0000005428 00000 n 0000005757 00000 n 0000005865 00000 n 0000005928 00000 n 0000006016 00000 n 0000006093 00000 n 0000006257 00000 n 0000006287 00000 n 0000006442 00000 n 0000006612 00000 n 0000006642 00000 n 0000006789 00000 n 0000006963 00000 n 0000007183 00000 n 0000007337 00000 n 0000007510 00000 n 0000007730 00000 n 0000007884 00000 n 0000008059 00000 n 0000008280 00000 n 0000008434 00000 n 0000008615 00000 n 0000008645 00000 n 0000008802 00000 n 0000008952 00000 n 0000008982 00000 n 0000009129 00000 n 0000009288 00000 n 0000009318 00000 n 0000009473 00000 n 0000009639 00000 n 0000009669 00000 n 0000009826 00000 n 0000009989 00000 n 0000010021 00000 n 0000010172 00000 n 0000010343 00000 n 0000010491 00000 n 0000010706 00000 n 0000010895 00000 n 0000011117 00000 n 0000011272 00000 n 0000011444 00000 n 0000011476 00000 n 0000011634 00000 n 0000011788 00000 n 0000011820 00000 n 0000011978 00000 n 0000012154 00000 n 0000012186 00000 n 0000012333 00000 n 0000012511 00000 n 0000012543 00000 n 0000012680 00000 n 0000012858 00000 n 0000012890 00000 n 0000013037 00000 n 0000013215 00000 n 0000013247 00000 n 0000013384 00000 n 0000013555 00000 n 0000013587 00000 n 0000013745 00000 n 0000013955 00000 n 0000014110 00000 n 0000014332 00000 n 0000014515 00000 n 0000014670 00000 n 0000014892 00000 n 0000015074 00000 n 0000015289 00000 n 0000015437 00000 n 0000015639 00000 n 0000015794 00000 n 0000016018 00000 n 0000016194 00000 n 0000016349 00000 n 0000016572 00000 n 0000016762 00000 n 0000016983 00000 n 0000017138 00000 n 0000017334 00000 n 0000017558 00000 n 0000017713 00000 n 0000017916 00000 n 0000018104 00000 n 0000018278 00000 n 0000018460 00000 n 0000018634 00000 n 0000018822 00000 n 0000019010 00000 n 0000019178 00000 n 0000019210 00000 n 0000019368 00000 n 0000019541 00000 n 0000019573 00000 n 0000019731 00000 n 0000019913 00000 n 0000019945 00000 n 0000020103 00000 n 0000020137 00000 n 0000020170 00000 n 0000020214 00000 n 0000020244 00000 n 0000020266 00000 n 0000020295 00000 n 0000020327 00000 n 0000020360 00000 n 0000020393 00000 n 0000020422 00000 n 0000020452 00000 n 0000020482 00000 n 0000020512 00000 n 0000020545 00000 n 0000020591 00000 n 0000020622 00000 n 0000020667 00000 n 0000020698 00000 n 0000020730 00000 n 0000020762 00000 n 0000020794 00000 n 0000020824 00000 n 0000020854 00000 n 0000020890 00000 n 0000020931 00000 n 0000020992 00000 n 0000021178 00000 n 0000021361 00000 n 0000021545 00000 n 0000021727 00000 n 0000028579 00000 n 0000039422 00000 n 0000039596 00000 n 0000039765 00000 n 0000039896 00000 n 0000040073 00000 n 0000040212 00000 n 0000040372 00000 n 0000040554 00000 n 0000040678 00000 n 0000040858 00000 n 0000041041 00000 n 0000041276 00000 n 0000041299 00000 n 0000041536 00000 n 0000041945 00000 n 0000062741 00000 n 0000062769 00000 n 0000063201 00000 n 0000063361 00000 n 0000063431 00000 n 0000063668 00000 n 0000064004 00000 n 0000064259 00000 n 0000064596 00000 n 0000097573 00000 n 0000097601 00000 n 0000097987 00000 n 0000098155 00000 n 0000098225 00000 n 0000098480 00000 n 0000098857 00000 n 0000099078 00000 n 0000099101 00000 n 0000099360 00000 n 0000099631 00000 n 0000127049 00000 n 0000127077 00000 n 0000127379 00000 n 0000127532 00000 n 0000127602 00000 n 0000127829 00000 n 0000127864 00000 n 0000140263 00000 n 0000140503 00000 n 0000140712 00000 n 0000140966 00000 n 0000004754 00000 n 0000004205 00000 n trailer<<283d7ca2aa2a0477060f5c8d5ca2cc48>] >> startxref 0 %%EOF 64 0 obj <>/AcroForm 65 0 R/Outlines 6 0 R/Metadata 9 0 R>> endobj 245 0 obj<
>stream xc`` I-* BM gxbBN$Ôw +SqqcJ\rˎM*}B2R~l~LR 8En*J.T:ARe; JwJ$J u%w|Ir^1(%fJ٩4m1qP[N99TR!Wr1N%T cJ$dU,VL|G6/ݔ/u|YdE>/t|_dn(u"שdtJ%UuńK*IJvJ&uL*R>ѩ(dmg;#\%tHµsR4:JA+&Y*pY?rYT<㫪Ǥ6N⍍I]H3fRYYM, endstream endobj 244 0 obj <>stream x" @Ax 22VӖE;՞4P:ұFkLSBLѭt͵R+=Izѫzӻ>/}G endstream endobj 65 0 obj <> endobj 66 0 obj <>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/MediaBox[0 0 612 792]/Contents 196 0 R/Group<>/Tabs/S/StructParents 0/Annots 67 0 R/CropBox[ 0 0 612 792]/Rotate 0>> endobj 67 0 obj [ 72 0 R 75 0 R 78 0 R 81 0 R 84 0 R 87 0 R 90 0 R 93 0 R 96 0 R 99 0 R 102 0 R 105 0 R 108 0 R 111 0 R 114 0 R 117 0 R 120 0 R 123 0 R 126 0 R 129 0 R 132 0 R 135 0 R 138 0 R 141 0 R 144 0 R 147 0 R 150 0 R 151 0 R 152 0 R 153 0 R 154 0 R 155 0 R 156 0 R 157 0 R 160 0 R 163 0 R 192 0 R 193 0 R 194 0 R 195 0 R] endobj 68 0 obj <>/Font<>/ProcSet[/PDF/Text]>> endobj 69 0 obj <> endobj 70 0 obj <> endobj 71 0 obj <> endobj 72 0 obj <> endobj 73 0 obj <> endobj 74 0 obj <>stream x endstream endobj 75 0 obj <> endobj 76 0 obj <> endobj 77 0 obj <>stream x endstream endobj 78 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 2 0 R/Rect[ 22.100006103 424.299987792 28.300003051 432]/Subtype/Widget/Type/Annot>> endobj 79 0 obj <>stream xs 2P t+ȝL33L ,Bry]|4^. M,^.Wy\ endstream endobj 80 0 obj <>stream x endstream endobj 81 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 2 0 R/Rect[ 58.100006103 424.299987792 64.29901123 432]/Subtype/Widget/Type/Annot>> endobj 82 0 obj <>stream xs 2P t+ȝL33L ,Bry]|4^. M,^.Wy\ endstream endobj 83 0 obj <>stream x endstream endobj 84 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 2 0 R/Rect[ 94.098999023 424.299987792 100.29901123 432]/Subtype/Widget/Type/Annot>> endobj 85 0 obj <>stream xs 2P t+ȝL63T0354S030VҏJtI r!i\ !Y\@Ӹ 2 endstream endobj 86 0 obj <>stream x endstream endobj 87 0 obj <> endobj 88 0 obj <> endobj 89 0 obj <>stream x endstream endobj 90 0 obj <> endobj 91 0 obj <> endobj 92 0 obj <>stream x endstream endobj 93 0 obj <> endobj 94 0 obj <> endobj 95 0 obj <>stream x endstream endobj 96 0 obj <> endobj 97 0 obj <> endobj 98 0 obj <>stream x endstream endobj 99 0 obj <> endobj 100 0 obj <> endobj 101 0 obj <>stream x endstream endobj 102 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 3 0 R/Rect[ 66 363.600006103 72.25 371.299987792]/Subtype/Widget/Type/Annot>> endobj 103 0 obj <>stream x endstream endobj 104 0 obj <>stream xs 2P t+ȝL13T035R030VҏJtI R!i\ !Y\@Ӹ endstream endobj 105 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 3 0 R/Rect[ 130.098999023 363.600006103 136.300003051 371.299987792]/Subtype/Widget/Type/Annot>> endobj 106 0 obj <>stream xs 2P t+ȝL63T0354S030VҏJtI r!i\ !Y\@Ӹ 2 endstream endobj 107 0 obj <>stream x endstream endobj 108 0 obj <> endobj 109 0 obj <> endobj 110 0 obj <>stream x endstream endobj 111 0 obj <> endobj 112 0 obj <> endobj 113 0 obj <>stream x endstream endobj 114 0 obj <> endobj 115 0 obj <> endobj 116 0 obj <>stream x endstream endobj 117 0 obj <> endobj 118 0 obj <> endobj 119 0 obj <>stream x endstream endobj 120 0 obj <> endobj 121 0 obj <> endobj 122 0 obj <>stream x endstream endobj 123 0 obj <> endobj 124 0 obj <> endobj 125 0 obj <>stream x endstream endobj 126 0 obj <> endobj 127 0 obj <> endobj 128 0 obj <>stream x endstream endobj 129 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Rect[ 166.098999023 238.548995971 172.300003051 246.25]/Subtype/Widget/T(Check_made_payable_to_ITEC)/Type/Annot/TU 180 0 R>> endobj 130 0 obj <>stream x endstream endobj 131 0 obj <>stream xs 2P t+ȝL63W0354S030VҏJtI --Bx4,4Bx\fq d) endstream endobj 132 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 4 0 R/Rect[ 469.699005126 238.548995971 475.898986816 246.25]/Subtype/Widget/Type/Annot>> endobj 133 0 obj <>stream x endstream endobj 134 0 obj <>stream xs 2P t+ȝL33W0354S030VҏJtIAjBx4,4Bx\q endstream endobj 135 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 4 0 R/Rect[ 518.648986816 238.548995971 524.898986816 246.25]/Subtype/Widget/Type/Annot>> endobj 136 0 obj <>stream xs 2P t+ȝL13W035R030VҏJtI --Bx4,4Bx\fq em) endstream endobj 137 0 obj <>stream x endstream endobj 138 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Rect[ 166.098999023 223.699996948 172.300003051 231.350006103]/Subtype/Widget/T(Credit_Card)/Type/Annot/TU 181 0 R>> endobj 139 0 obj <>stream x endstream endobj 140 0 obj <>stream xs 2P t+ȝL633T0354S0327QҏJtI --Bx4,4Bx\q A endstream endobj 141 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 5 0 R/Rect[ 166.098999023 206.899002075 173.5 215.75]/Subtype/Widget/Type/Annot>> endobj 142 0 obj <>stream x endstream endobj 143 0 obj <>stream xs 2P t+ȝ\̶г0U0334S0317UҏJtI --Bx4,4Bx\q vzg endstream endobj 144 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 5 0 R/Rect[ 213.348999023 206.899002075 220.800003051 215.75]/Subtype/Widget/Type/Annot>> endobj 145 0 obj <>stream xs 2P t+ȝ\̱г 2̌LMBry]|CKK4^. M,^.Wa\ vg endstream endobj 146 0 obj <>stream x endstream endobj 147 0 obj <>>>/AS/Off/F 4/FT/Btn/H/T/P null/Parent 5 0 R/Rect[ 300.699005126 206.899002075 308.148986816 215.75]/Subtype/Widget/Type/Annot>> endobj 148 0 obj <>stream xs 2P t+ȝ\̳г0U033R0317UҏJtI --Bx4,4Bx\q endstream endobj 149 0 obj <>stream x endstream endobj 150 0 obj <>/F 4/FT/Tx/Ff 29360128/P null/Rect[ 501.850006103 191.048995971 561.849975585 204.699996948]/Subtype/Widget/T(Credit_Card_Security_Code)/Type/Annot/TU 182 0 R/MaxLen 3>> endobj 151 0 obj <>/F 4/FT/Tx/Ff 29360128/P null/Rect[ 85.201370239 178.548614501 140.400360107 192.198608398]/Subtype/Widget/T(Card_Number)/Type/Annot/TU 183 0 R/MaxLen 4>> endobj 152 0 obj <>/F 4/FT/Tx/Ff 29360128/P null/Rect[ 149.5 177.850006103 204.699005126 191.5]/Subtype/Widget/T(Card_Number0)/Type/Annot/TU 184 0 R/MaxLen 4>> endobj 153 0 obj <>/F 4/FT/Tx/Ff 29360128/P null/Rect[ 213.098999023 177.850006103 268.100006103 191.5]/Subtype/Widget/T(Card_Number1)/Type/Annot/TU 185 0 R/MaxLen 4>> endobj 154 0 obj <>/F 4/FT/Tx/Ff 29360128/P null/Rect[ 276.5 177.850006103 331.699005126 191.5]/Subtype/Widget/T(Card_Number2)/Type/Annot/TU 186 0 R/MaxLen 4>> endobj 155 0 obj <>/F 4/FT/Tx/Ff 29360128/P null/Rect[ 454.299987792 177.350006103 508.799987792 187.899002075]/Subtype/Widget/T(Textfield3)/Type/Annot/TU 187 0 R/MaxLen 2>> endobj 156 0 obj <>/F 4/FT/Tx/Ff 29360128/P null/Rect[ 511.699005126 177.350006103 561.849975585 191.048995971]/Subtype/Widget/T(Textfield4)/Type/Annot/TU 188 0 R/MaxLen 4>> endobj 157 0 obj <> endobj 158 0 obj <> endobj 159 0 obj <>stream x endstream endobj 160 0 obj <> endobj 161 0 obj <> endobj 162 0 obj <>stream x endstream endobj 163 0 obj <> endobj 164 0 obj <> endobj 165 0 obj <>stream x endstream endobj 166 0 obj (Resident_State) endobj 167 0 obj (Insurance_Lic) endobj 168 0 obj (Preferred_Name_for_Badge) endobj 169 0 obj (First_Name) endobj 170 0 obj (MI) endobj 171 0 obj (Last_Name) endobj 172 0 obj (Designations) endobj 173 0 obj (Date_of_Birth) endobj 174 0 obj (AgencyCompany) endobj 175 0 obj (Textfield) endobj 176 0 obj (Textfield0) endobj 177 0 obj (Textfield1) endobj 178 0 obj (Textfield2) endobj 179 0 obj (EMail_Address) endobj 180 0 obj (Check_made_payable_to_ITEC) endobj 181 0 obj (Credit_Card) endobj 182 0 obj (Credit_Card_Security_Code) endobj 183 0 obj (Card_Number) endobj 184 0 obj (Card_Number0) endobj 185 0 obj (Card_Number1) endobj 186 0 obj (Card_Number2) endobj 187 0 obj (Textfield3) endobj 188 0 obj (Textfield4) endobj 189 0 obj (Cardholders_Name) endobj 190 0 obj (Cardholders_Signature) endobj 191 0 obj (Credit_card_billing_address_with_zip_code) endobj 192 0 obj <>>> endobj 193 0 obj <>>> endobj 194 0 obj <>>> endobj 195 0 obj <>>> endobj 196 0 obj <>stream x]{sȑUH]L`/זs2-'Jٲ=6T&!?ܷ~@![w/&_Ltzζѷ>9nj|u'Փr]ϞE_L<~T8_6T'i<ΣGONoUXE=~TGUUEycM]ǟ?aZ{Ա$L@#}d/~Ơ"䠴uWLWrudHe%k&$I/♅Gi$g)S$Ibinɳ# i[N3 h~҂r[#JZS觅d]@W&/