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Directory Results for 20152016 ADULT MEDICAL RELEASE (To be completed by participant) FIRST PRESBYTERIAN CHURCH 1000 Penn Street, Fort Worth, Texas 76102 (817) 3351231 Date form filled out Name Birth Date Address Phone City State Zip Please note any medical to 20152016 Advance Payments Program Application Individuals To apply for a 20152016 APP advance please complete the s in this document as well as the form packet for your particular commodity which can be found on our website at www - - -