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Sample Letter of Agreement 2 and/or this program, made by or under the authority of the Sponsor, in which the composer may appear, 3. furnish Sponsor with a photograph suitable for scanning, and a complete biography within 30 days of Composer’s signing of this Agreement, 4. provide Sponsor with timely reports (every two months?

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(If application has been made and funding denied, please attach their denial letter.) 4.Method of Supply: concentrator (including back-up and portable cylinders) cylinder (compressed oxygen for stationary and/or portability) 5.Name of Oxygen Vendor (if available) 6.Is oxygen required: As a result of a work related injury? Yes . No

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