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EFW Enrollment Form

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1. Business Name:

 Tracey
 (3%) 
 
 Lemongrass Spa
 (6%) 
 
 Fun Town Family Entertainment Center
 (6%) 
 
 Joe Raley State Farm Agency
 (3%) 
 
 Dr. Claire Stagg Health Centered Dentistry
 (3%) 
 
 IAP Worldwide Services, Inc.
 (3%) 
 
 The Children's Hunger Project
 (3%) 
 
 KSC Education Office
 (3%) 
 
 Rolling Readers Space Coast, Inc.
 (3%) 
 
 Community Credit Union of Florida
 (3%) 
 
 UNO Chicago Grill
 (3%) 
 
 Jersey MIke's Subs
 (9%) 
 
 Martin
 (3%) 
 
 pintop
 (3%) 
 
 JJ & Co
 (13%) 
 
 lisa welch
 (3%) 
 
 cannabis funding 
 (3%) 
 
 HVAC Clinton Township Michigan
 (3%) 
 
 male health
 (3%) 
 
 supplementguide
 (3%) 
 
 testosterone boosters
 (3%) 
 
 fitnessguidefg.com
 (3%) 
 
 guideonhcg
 (3%) 
 
 authorityproductshop
 (3%) 
 
 findbodyinshape
 (3%) 
 

Total: 32

2. Business Mailing Address:

 kcjwkjcok
 (3%) 
 
 2607 Kendrick Court
 (6%) 
 
 P.O. Box 121669 West Melbourne FL 32904-9998
 (3%) 
 
 5030 Minton Road NW, Ste 1 Palm Bay
 (3%) 
 
 2120 HWY A1A
 (3%) 
 
 7315 North Atlantic Ave., Cape Canaveral
 (3%) 
 
 2087 Sarno Rd.
 (3%) 
 
 Fun Town PO Box 121669 W. Melbourne Fl 32904
 (3%) 
 
 Mailcode: EX-E
 (3%) 
 
 1948 Pineapple Ave. Melbourne
 (3%) 
 
 1030 South US 1, Rockledge
 (3%) 
 
 8260 N. Wickham Rd Melbourne
 (3%) 
 
 1070 N. Wickham Road
 (3%) 
 
 90 W. Hibiscus Blvd.
 (3%) 
 
 1515 Palm Bay Road
 (3%) 
 
 pit@wwwo.com
 (3%) 
 
 pin@gmail.com
 (3%) 
 
 Hilton Austin, East 4th Street, Waller Creek District, Austin, TX, USA
 (13%) 
 
 lisawelch939@gmail.com
 (3%) 
 
 usa,califona
 (3%) 
 
 usa,california
 (3%) 
 
 lucywilliams333@gmail.com
 (3%) 
 
 supplementguide23323@gmail.com
 (3%) 
 
 http://www.getbodyinshape.net
 (3%) 
 
 fitnessguidefg2323@gmail.com
 (3%) 
 
 guideonhcg2334@gmail.com
 (3%) 
 
 authorityproduct2333@gmail.com
 (3%) 
 
 findbodyin2343@gmail.com
 (3%) 
 

Total: 32

3. Suite or Building Number:

 jqkmcqk
 (13%) 
 
 1976 N. Wickham Rd.Melbourne
 (13%) 
 
 1976 N. Wickham rd. Melbourne
 (13%) 
 
 HQ
 (13%) 
 
 Suite 102A
 (13%) 
 
 #160
 (13%) 
 
 7
 (13%) 
 
 HVAC Clinton Township Michigan
 (13%) 
 

Total: 8

4. State:

 FL
 25 (78%) 
 
 TX
 (9%) 
 
 California
 (6%) 
 
 Hawaii
 (3%) 
 
 New York
 (3%) 
 

Total: 32

5. Zip Code:

 32955
 (8%) 
 
 32904
 (8%) 
 
 32935
 (21%) 
 
 32907
 (4%) 
 
 32937
 (4%) 
 
 32920
 (4%) 
 
 32899
 (4%) 
 
 32940
 (4%) 
 
 32901
 (8%) 
 
 433423
 (4%) 
 
 73301
 (13%) 
 
 10010
 (13%) 
 
 10020
 (4%) 
 

Total: 24

6. Business Phone:

 wecwcwc
 (3%) 
 
 321-258-5302
 (6%) 
 
 321-253-4777
 (6%) 
 
 321-723-0333
 (3%) 
 
 321-777-2797
 (3%) 
 
 321-784-7100
 (3%) 
 
 321-373-7083
 (3%) 
 
 321-867-3623
 (3%) 
 
 (321) 254-9976
 (3%) 
 
 321 690 2328
 (3%) 
 
 321-255-1400
 (3%) 
 
 321-622-8813
 (3%) 
 
 321-821-4483
 (3%) 
 
 321-473-8996
 (3%) 
 
 765434567
 (3%) 
 
 22541233
 (3%) 
 
 7132264145
 (13%) 
 
 7854125658
 (3%) 
 
 7854125497
 (3%) 
 
 7656547643
 (3%) 
 
 323333
 (6%) 
 
 111123222
 (3%) 
 
 34555
 (3%) 
 
 34333
 (3%) 
 
 34344444
 (3%) 
 
 43444
 (3%) 
 

Total: 32

7. Business Website:

 wvwvwv
 (4%) 
 
 www.ourlemongrassspa.com/Cameron
 (8%) 
 
 www.funtownfl.com
 (8%) 
 
 www.JoeRaley.com
 (4%) 
 
 www.SmileProfessionals.com
 (4%) 
 
 www.iapws.com
 (4%) 
 
 http://www.thechildrenshungerproject.org
 (4%) 
 
 www.rollingreadersspacecoast.com
 (4%) 
 
 www.ccuflorida.org
 (4%) 
 
 974@unos.com
 (4%) 
 
 www.jerseymikes.com
 (12%) 
 
 https://shapeandbody.eu/
 (4%) 
 
 https://www.hardmenstore.com/noxitril-review/
 (4%) 
 
 https://cannabisstartuploans.com/
 (4%) 
 
 https://www.clintontownshipheatingcooling.com/
 (4%) 
 
 http://www.naturalproductsinfo.net/
 (4%) 
 
 http://www.supplementguidesg.net
 (4%) 
 
 http://www.getbodyinshape.net/best-testosterone-boosters.html
 (4%) 
 
 http://www.fitnessguidefg.com
 (4%) 
 
 http://www.guideonhcgdrops.com
 (4%) 
 
 http://www.authorityproductshop.com/
 (4%) 
 
 http://www.findbodyinshape.net/max-gains-legal-steroids-for-women.html
 (4%) 
 

Total: 26

8. Name of Chief Executive Officer:

 wvwvwv
 (5%) 
 
 Cameron Cahill
 (10%) 
 
 Allana Antonio
 (5%) 
 
 Joe Raley
 (5%) 
 
 Dr. Claire Stagg
 (5%) 
 
 Spence Wickham
 (5%) 
 
 Bob Barnes
 (5%) 
 
 Anthony Catalano
 (5%) 
 
 Susan Thomas
 (5%) 
 
 David Brock
 (5%) 
 
 Ian Baines
 (5%) 
 
 Bryan Price
 (14%) 
 
 ceo
 (5%) 
 
 lisa welch
 (5%) 
 
 https://cannabisstartuploans.com/
 (5%) 
 
 Furnace Clinton Township Michigan
 (5%) 
 
 lucy smith
 (10%) 
 

Total: 21

9. Number of Employees:

 1
 (16%) 
 
 4
 (6%) 
 
 25
 (6%) 
 
 9
 (3%) 
 
 6
 (3%) 
 
 220
 (3%) 
 
 2
 (9%) 
 
 21
 (3%) 
 
 3
 (3%) 
 
 100
 (3%) 
 
 50
 (3%) 
 
 12
 (22%) 
 
 7
 (3%) 
 
 5
 (3%) 
 
 7,854,125,687
 (3%) 
 
 78,548,545
 (3%) 
 
 33,432
 (3%) 
 
 343
 (3%) 
 

Total: 32

10. Education Friendly Workplace (EFW) Liaison:

 wvwew
 (3%) 
 
 self
 (6%) 
 
 Allana Antonio
 (6%) 
 
 Joe Raley
 (3%) 
 
 Vanessa Steele
 (3%) 
 
 Arlene Mellinger
 (3%) 
 
 Sarah Anthony
 (3%) 
 
 Lesley Fletcher
 (3%) 
 
 Susan Thomas
 (3%) 
 
 Deborah blair
 (3%) 
 
 Susie Parente
 (3%) 
 
 Nadine Smith
 (9%) 
 
 dr
 (3%) 
 
 PInto
 (3%) 
 
 yes
 (13%) 
 
 EFW
 (3%) 
 
 We are helping entrepreneur's obtain funding so they can get into the booming cannabis industry. They can use the money for farming, CBD, dispensaries, or any other speciality within the industry. https://cannabisstartuploans.com/
 (3%) 
 
 usa
 (13%) 
 
 uk
 (6%) 
 
 london
 (3%) 
 
 United States
 (3%) 
 

Total: 32

11. EFW Phone:

 wvwvw
 (3%) 
 
 same
 (6%) 
 
 321-253-4777
 (6%) 
 
 321-723-0333
 (3%) 
 
 321-482-8996
 (3%) 
 
 321-784-7147
 (3%) 
 
 321-446-8941
 (3%) 
 
 321-867-3623
 (3%) 
 
 (321) 254-9976
 (3%) 
 
 321 795 0624
 (3%) 
 
 321-255-140
 (3%) 
 
 321-213-7196
 (9%) 
 
 67823458
 (3%) 
 
 65852663366
 (3%) 
 
 7132264145
 (13%) 
 
 7854125658
 (3%) 
 
 We are helping entrepreneur's obtain funding so they can get into the booming cannabis industry. They can use the money for farming, CBD, dispensaries, or any other speciality within the industry. https://cannabisstartuploans.com/
 (3%) 
 
 364756473
 (3%) 
 
 23233
 (3%) 
 
 232222
 (3%) 
 
 434444
 (3%) 
 
 34555
 (3%) 
 
 343333343
 (3%) 
 
 232333
 (3%) 
 
 32343
 (3%) 
 

Total: 32

12. EFW Email:

 wvwvw
 (4%) 
 
 LemongrassbyCameron@gmail.com
 (7%) 
 
 allana@funtownfl.com
 (7%) 
 
 Joe@JoeRaley.net
 (4%) 
 
 staggmarketing@gmail.com
 (4%) 
 
 arlene.j.mellinger@iapws.com
 (4%) 
 
 sarah@thechildrenshungerproject.org
 (4%) 
 
 lesley.fletcher@nasa.gov
 (4%) 
 
 read@rollingreadersspacecoast.com
 (4%) 
 
 974@unos.com
 (4%) 
 
 nysfl@aol.com
 (11%) 
 
 alexanderson7415@gmail.com
 (4%) 
 
 andrewjohns680@gmail.com
 (7%) 
 
 lisawelch939@gmail.com
 (4%) 
 
 We are helping entrepreneur's obtain funding so they can get into the booming cannabis industry. They can use the money for farming, CBD, dispensaries, or any other speciality within the industry. https://cannabisstartuploans.com/
 (4%) 
 
 aron@shitmail.de 
 (4%) 
 
 http://www.naturalproductsinfo.net/vigrx-plus-review.html
 (4%) 
 
 http://www.supplementguidesg.net/testogen-reviews.html
 (4%) 
 
 http://www.getbodyinshape.net/best-testosterone-boosters.html
 (4%) 
 
 http://www.fitnessguidefg.com/crazy-bulk-supplements-review.html
 (4%) 
 
 <a href="http://www.guideonhcgdrops.com/buy-hcg-injections-for-weight-loss.html">hcg injections For Lose Weight</a>
 (4%) 
 
 http://www.authorityproductshop.com/testogen-review-lean-muscle.html
 (4%) 
 
 http://www.findbodyinshape.net/max-gains-legal-steroids-for-women.html
 (4%) 
 

Total: 28

13. Additional Comments/Questions:
List here or contact Ginger Blair at 321.633.1000, ext 644 or blair.ginger@brevardschools.org

 
wbvwrvwv
 (4%) 
 
 
We are a business wanting more infomation on this program. We proudly support our community and the public schools.
 (4%) 
 
 
 (24%) 
 
 
We are a corporate store. Leticia Acosta is the General Manager at this location. However, Susie Parente and Megan Poulsen are marketing coordinators in the community and will be your main contact person.
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