Re-Sign Form

Please use the following form to re-sign Between the 10th and the 16th of each month.  The re-sign must be received by 11:59 p.m. EST.


1) Provide your information on the lines below.

2) Use one of the following options to re-sign:

a. Fax this completed form by your re-sign date to Fax: (717) 232-7113

b. send form by US mail, Must be post marked between the 10th thru the 16th

c. sign in person at the hall


Please make sure that you have been approved and are logged in prior to completing this form!
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