Athlete Agent Registration Page 3

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kansas secretary of state
AA
Athlete Agent Registration
81
Appendix A
Use additional sheets as necessary.
List the business(es) or occupation(s) the applicant engaged in for the five (5) years immediately preceding the date of this
application or renewal request.
Business or occupation
Address
City
State
Zip
Dates
Name of supervisor
Duties
Business or occupation
Address
City
State
Zip
Dates
Name of supervisor
Duties
Business or occupation
Address
City
State
Zip
Dates
Name of supervisor
Duties
2 / 8
Please continue to next page.
L. 2003, Ch. 109
Rev. 6/25/15 tc

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