GIMME 10 FORM - CHAPTER #KS______, ________________
TOPSŪNAME
WEIGHT 1/1/08
WEIGHT 12/31/08
POUNDS LOSS
WEIGHT 12/31/08
POUNDS LOSS
KOPSŪNAME - GOAL WEIGHT - In leeway
all year long.
RUN OFF EXTRA IF NEEDED
Return form to Beverly Bednasek, 410 Fieldstone, Valley Center, Kansas
67147