AMERICAN MULE ASSOCIATION	Date Submitted ______________

LEVA AWARD PROGRAM	Date Received _______________
(Long Ears Versatility Award)
	initial _______

MULE _______________________________	AMA# ______________________

RIDER ______________________________	AMA# ______________________

DATE	DESCRIPTION OF EVENT	SPONSOR/SIGNATURE	POINTS


	Submit forms monthly to:

	Bernita Garcia
	1464 Beulah street
	Hanford, Ca. 93230-3113

Last Revised 09/20/04

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