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Get Western World Lifeguard Services Application Form

1. Name of Applicant Street Address State City Zip Applicant s Web Site Address 2. Type of Organization Individual Partnership Corporation Other (Please explain.) Years in Business 3. Date Established 4. Name of Contact Person for Inspection Telephone Number 5. Has the applicant had prior insurance for this enterprise? (If yes, please complete the following.) Insurance Company Policy Period Limits of Liability Premium Yes Type of Coverage No Occurrence or Claims Made 6. Durin.

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