PRE-EXAMINATION BOOKLET
FOR
DEPARTMENTAL RECORDS CLERK
ENTRANCE LEVEL EXAMINATION
Prepared by the Office of State Examiner
Municipal Fire and Police Civil Service
Testing and System Services Division
Revised 12/2021
DO NOT BRING THIS BOOKLET TO THE EXAM SITE
INTRODUCTION
One of the first steps toward becoming a departmental records clerk within the Municipal Fire
and Police Civil Service System is successfully passing a civil service examination which is
administered by the Office of State Examiner for Municipal Fire and Police Civil Service. This
booklet will provide you with important information about the examination process, helpful
hints on taking tests, and sample questions that are similar to those on the Departmental
Records Clerk Examination.
You do not need to have a previous knowledge of fire and/or police department work to pass
this examination. The test has been designed to evaluate knowledge, skills, and abilities that
are needed to successfully complete on-the-job training as a departmental records clerk.
For example, in order to successfully complete training, you must be able to read and
comprehend training on procedures. Therefore, part of the written examination contains a
section of questions on reading comprehension based on material similar to that which must
be read on the job.
BRIEF DESCRIPTION OF THE TEST
The Departmental Records Clerk Exam is a multiple-choice exam consisting of 100
questions which are divided into the seven subject areas listed below. You will have one
hour and fifty minutes in which to complete the examination.
OFFICE PRACTICES AND PROCEDURES
This section is designed to evaluate your knowledge of clerical practices and office
procedures sufficient to process mail, handle telephones and convey messages, and to
operate office equipment, including office software.
FILING PROCEDURES
A departmental records clerk must have the knowledge of effective filing procedures
sufficient to organize and maintain departmental records in numerical, alphabetical, and
chronological order and according to subject matter.
RECORDS/REPORTS/ WRITTEN COMMUNICATION
In order to be a successful departmental records clerk, you must have the knowledge of
practices and procedures utilized for records and report preparation involving the
compilation, analysis, and organization of information and data into a written format,
including knowledge of English usage and grammar sufficient for effective written
communications or to correct spelling, grammar, and punctuation.
SUBJECT AREA
PERCENTAGE OF
WRITTEN TEST
OFFICE PRACTICES AND PROCEDURES
28%
FILING PROCEDURES
14%
RECORDS/REPORTS/WRITTEN COMMUNICATIONS
21%
READING COMPREHENSION
14%
PUBLIC RELATIONS
6%
PROOFREADING
7%
MATHEMATICS/ARITHMETIC
10%
TOTAL
100%
READING COMPREHENSION
A departmental records clerk must have the ability to read and comprehend materials
such as manuals, procedure sheets, reports, and instructions.
PUBLIC RELATIONS
While dealing with the members of the public through telephone or in person, a departmental
records clerk will need knowledge of effective public relations practices that foster a positive
public image of the department through contact with the public.
PROOFREADING
This section is designed to evaluate your ability to detect errors and/or differences between
two sets of written material (or an original and a copy).
MATHEMATICS/ARITHMETIC
This section is designed to evaluate your knowledge of mathematic and arithmetic basic
principles sufficient to perform simple computations.
HOW THE TEST IS GRADED
All exams are graded in Baton Rouge at the Office of State Examiner. To pass the
examination and be considered for employment, you must score 75 or above.
HOW TO USE THIS STUDY GUIDE
You may practice your test taking skills by answering the sample questions provided in this
booklet. If you desire further practice, you may also obtain books from your local library that
contain sample civil service test questions. Should you decide to use additional practice
material, it would be most beneficial to practice on the questions that are similar to the sample
questions in this booklet.
When you get to the practice exam, separate the papers that follow. Take the Scantron answer
sheet and the blank scratch sheet and write your name on them (that will be explained on the
next page). When you are finished, use the answer key to see which ones you answered
correctly. Read the explanations for each answer. This will help in understanding why your
answer may have been incorrect.
HOW TO USE THE SPECIAL ANSWER SHEET
When you take the Departmental Records Clerk Examination, you will record your answers on
a separate answer sheet rather than directly into the test booklet. A sample answer sheet and
a blank scratch sheet have been provided at the back of this booklet. Prior to the examination,
you will be given detailed instructions on how to fill in the required information on the answer
sheet. The front of the answer sheet contains personal information such as your name and social
security number as well as information about the jurisdiction. You must follow the examiner's
directions exactly so that your
responses may be correctly scanned into the computer.
Some of the information requested on the answer sheet requires that you print information in
blocks. After you have printed the required information in the blocks, you must also fill in the
oval in the vertical column below each block which corresponds to the letter or number
written in the block. The first row of boxes is for your name. In the example on the next page,
John E. Smith entered his name in the boxes by placing one letter in each box, while skipping
a space (block) between each name or initial. Once his name was correctly printed in the
boxes, the oval corresponding to that letter in the column below was filled in.
In the example below under the word "IMPORTANT", answer "3" was chosen as the correct answer
and the oval was filled in completely for answer choice “3.” If you decide to change your answer
choice, erase your original mark completely, then darken your new answer choice. Do not make
any stray marks on the answer sheet.
The back of the answer sheet contains more information about the examination. On the sample
answer sheet, find Box #12. This is where you will record your answers to the test questions.
In recording your answer choices, you should only use the No. 2 pencils provided at the exam
site and mark only one answer for each question number. It is extremely important that you make
your mark dark and that you completely fill the oval with your mark.
HOW TO TAKE THE WRITTEN MULTIPLE-CHOICE TEST
The written examination is divided into seven sections. The next part of this study guide
booklet contains sample questions from each of the seven sections. Before you begin, become
familiar with these helpful hints for taking a multiple-choice test:
1.
Know the Rules.
The Examiner will be the person in charge of the exam. Listen carefully when
he/she gives the test instructions. If you have any questions, ask the Examiner. There may be
others who have the same questions but are afraid to ask. You will
not
be allowed to use a
calculator for the test nor will you be allowed to leave the room or use tobacco products during
the test. You are not allowed to have a cell phone or other electronic communication devices
(smart watch, pager, radio, etc.) in your possession. Please leave them in your vehicle or with
the person who dropped you off at the exam site.
2.
Budget Your Time.
Before you begin the test, look it over and decide how much time you can
spend on each section. Do not waste time trying to answer the questions that you find hard,
since this may not leave you enough time to do the easier ones. All questions are counted the
same. This means that you get the same credit for correctly answering the easier questions as
you do for the hard questions. Therefore, answer easier ones first, then go back to the harder
ones if you have time. The Examiner will notify you after you have been working for 1 hour and
then when there are 15 minutes remaining of the exam time. Use this information to pace
yourself.
3.
Read the Questions Carefully.
Read all of the questions and directions carefully. Do not
assume that you know what a question is asking after reading the first few words. Read the
entire question. After you have read a question, read
all
of the possible answer choices. Your
task is to pick out the best answer. You cannot pick out the best answer until you know all of
the answer choices, so read them all.
4.
Set Aside Wrong Choices.
If you are not sure which answer is correct, eliminate the choices
you know are wrong. If you can narrow down the number of choices, you can increase your
chances of answering the question correctly.
5.
Answer All Questions.
Answer every test question. Even if you are unsure of the correct
answer, you should still choose one of the four answer choices as you will not be penalized
for guessing.
6.
Check Your Answer Sheet Often.
The answer sheet is numbered from top to bottom. Before
you start the test, look over the answer sheet. If you have any questions, ask the Examiner
before you start. While taking the test, check your answer sheet every few questions to be
sure you are using the right number to mark your answer. Be particularly careful if you skip
questions. Do not make any extra marks on your answer sheet. If you skip a question it is better
to make a note of it on your scratch paper.
7.
Do Not Write in the Test Booklet.
Scratch paper will be provided. Do any figuring or make any
notes on the scratch paper. Do not make any marks in or on the test booklet.
8.
Do Your Own Work.
Rely on your own ability. Test takers who are caught copying are
disqualified. Besides, your neighbor may not know as much as you do.
9.
Check Your Work.
After you have answered all the questions on the test, check your work.
Have you answered all the questions you were supposed to answer? Make sure you have
marked the answer sheet properly. When you review the answer sheet, do not look for patterns
in order of answer choices. Tests are not designed to have patterns for correct answers.
Specific hints for the various subject areas on the test:
Office Practices and Procedures:
In this section, you will be asked questions pertaining to
general office procedures such as telephone usage and etiquette, email functions, copying
machine usage, postal mail, filling out forms, and following written procedures.
Filing Procedures:
This section of the exam will test your knowledge of filing procedures
both alphabetically and chronologically.
Records/Reports/ Written Communications:
You will be examined on your ability to
recognize correct grammar and word usage by choosing from among words or sentences
which are correct for their usage in the scenario. You will also answer questions that test
your ability to read a chart and answer questions based on the information contained in the
chart.
Reading Comprehension:
Select the one statement which is best supported by the paragraph
using only the information provided in the paragraph. Three of the choices may or may not be
correct information, but the information is not contained in the paragraph and cannot be
determined as correct from reading the paragraph. The correct answer is the only statement
which can be determined as correct from reading the information contained in the
paragraph. Read the entire excerpt before attempting to answer the questions.
Public Relations: This portion of the exam will test your general knowledge in acceptable public
relations practices in the public sector and other professional settings.
Proofreading: You will be tested on your ability to notice details which are different from one set
of information to the next set of information. For instance, an address written twice with
information which is slightly different from the original to the second version such as zip code,
PO Box, etc.
Mathematics: This section contains simple math problems that you will need to be able to solve
using addition, subtraction, multiplication, and division. A working knowledge of the
Mathematical Order of Operations may be required to correctly answer some of the items.
PRACTICE EXAM
This section of your study guide contains practice questions that are very similar to those on the
test. You may practice marking your answers on the sample answer sheet. A discussion of the
correct answers is located at the end of this booklet.
DIRECTIONS: Read each question and its lettered answers, and decide which answer is best.
Find the space lettered the same as the answer you have chosen and blacken this space with
your pencil. Be sure that the space you mark is in the row numbered the same as the
question you are answering. Be sure to make your marks dark and fill in the oval
completely with your mark. If you decide to change an answer, erase completely and mark
your new answer choice.
1. Malinda, owner of the local hardware store, has just called the department. She is asking you
about a matter that you are unfamiliar with and do not know how to handle. What should you
do in this situation?
A. Place the caller on hold for as long as it takes for her to hang up.
B. Tell the caller you do not know the answer and cannot help her and hang up.
C. Transfer the call to anyone available so that you don’t have to worry about it.
D. Place the caller on hold while you attempt to resolve the issue or find someone who can.
2. A document that is currently printed only on one side of paper needs to be copied so that it
prints on both sides of the paper, therefore using half as much paper as the original. Which
option on the copier would you chose for this print job?
A. 1 sided -----> 1 sided.
B. 1 sided -----> 2 sided.
C. 2 sided -----> 1 sided.
D. 2 sided -----> 2 sided.
3. When sending an email, what function would you use “Bcc:” for?
A. To forward an email to one recipient.
B. To send an attachment with an email.
C. To send copies of the email to multiple recipients without all of the emails being visible to
each recipient.
D. To reply to an email that you have recently received.
Use the excerpt below, from a telephone directory, to answer questions 4 - 6.
4. What is the direct number for the Human Resources Department?
A. 243-6174.
B. 243-6161.
C. 243-3340.
D. 243-3310.
5. What is the name of the Nurse Manager in the OR Department?
A. Dr. Bert Parker.
B. Judy Godwin.
C. Mandy Thompson.
D. Georgia Jones.
6. Telephone number 243-3340 is the fax number for which department?
A. OR.
B. OB/GYN.
C. Human Resources.
D. Health Information Management.
Your name is Janice Landry and you are a records clerk for the City of Urbandale. Your
supervisor has asked you to complete an inventory report, including inventory quantity
and costs of office supplies currently available, for the department. After counting the
inventory on hand, you find that you have the following supplies:
Large Paper Clips (100 ct. box)
4 boxes
$3.50/box
1-inch Binders
12
$5.00/each
Black Ink Pens
35
$1.00/each
Notepads
14
$2.00/each
Copy Paper (10 reams per box)
4 boxes
$35.00/box
16G Flash Drives
8
$5.00/each
Tape
10 rolls
$1.75/roll
You must use the information that you have just collected to fill in the inventory
spreadsheet shown below. Please answer questions 7 - 10 pertaining to the
spreadsheet.
7. For block “A” on the spreadsheet what value should be entered?
A. 14
B. 12
C. 35
D. 8
8. For block “B” on the spreadsheet, what value should be entered?
A. $1.00/each
B. $3.50/box
C. $1.75/roll
D. $5.00/each
INVENTORY
ITEM DESCRIPTION
NUMBER
OF ITEMS
COST PER
ITEM
TOTAL
COST
Black Ink Pens
A
$1.00
/each
$35.00
Large Paper Clips (100 count box)
4
$3.50/box
$14.00
Tape
10
$1.75/roll
$17.50
16G Flash Drives
8
B
$40.00
Copy Paper (10 reams per box)
4
$35.00/box
C
1-inch Binders
12
$5.00/each
$60.00
Notepads
D
$2.00/each
$28.00
Total Cost of Inventory
$334.50
9. What value should be entered into block “C” on the spreadsheet?
A. $35.00
B. $40.00
C. $60.00
D. $140.00
10. What value should be entered into block “D” on the spreadsheet?
A. 10
B. 12
C. 14
D. 35
11. For the following question, you are to select the name which would be filed FIRST if the
names were in correct alphabetical order. Then blacken in your choice on the answer sheet.
A. Johnson, George
B. Jones, Lindsey
C. Johnson, Barbara
D. Johnston, Alexander
Use the file cards below to answer questions 12 - 14.
12. If you wish to arrange the cards alphabetically according to the names on the cards, they
would appear in the following order.
A. B, C, D, A.
B. B, A, D, C.
C. B, D, C, A.
D. B, A, C, D.
13. If you wish to arrange the cards chronologically, they would be arranged in the following
order.
A. D, A, B, C.
B. D, C, A, B.
C. D, B, C, A.
D. D, A, C, B.
14. If you wish to arrange the cards numerically, they would be arranged in the following order.
A. A, B, C, D.
B. A, C, B, D.
C. A, B, D, C.
D. A, D, B, C.
15. In which of the following drawers would the number 5,128 be found?
A. 5,000 -- 5,100.
B. 5,101 -- 5,200.
C. 5,201 -- 5,300.
D. 5,301 -- 5,400.
16. Using your scratch paper, arrange the following in chronological order. Select your answer
from the numbered choices below.
A. 12:01 p.m. C. 3:00 p.m.
B. 1:00 p.m. D. 11:59 p.m.
A. B, C, D, A.
B. A, B, C, D.
C. A, C, B, D.
D. B, D, A, C.
For question number 17, you are given a word which you are to classify. Use the instructions
given below to mark the answer sheet as follows.
Mark “ A” if the second letter is “ e” , and the third letter is “ a” .
Mark “ B” if the second letter is “ r” , the third letter is “ a” , and the final letter is “ h” .
Mark “ C” if the second letter is not “ e” , the third letter is anything but “ t” , and the
fourth letter is anything but “ h” .
Mark “ D” if the word cannot be classified in any of these three categories.
17. Breath
18. Which of the following sentences is punctuated CORRECTLY? Mark the answer sheet with
the letter of the correct sentence.
A. Remember that your always supposed to set you’re clock back one hour when Daylight
Savings Time ends.
B. Remember that you’re always supposed to set you’re clock back one hour when Daylight
Savings Time ends.
C. Remember that you’re always supposed to set your clock back one hour when Daylight
Savings Time ends.
D. Remember that your always supposed to set your clock back one hour when Daylight
Savings Time ends.
In the sentences below, choose the one word that completes each sentence CORRECTLY.
19. I will _________________ my book report tomorrow.
A. Write
B. Right
C. Rite
D. Wright
20. I think ______________ going to regret not wearing a jacket today.
A. There
B. They’re
C. Their
D. Thare
Your name is Daisy Jones and you are the owner of Daisy’s Dog Walking and Daycare. You
currently have 5 employees. The chart below shows how many dogs each employee was
responsible for each day of the past week. Read the chart and then answer questions 21 –
24 pertaining to the chart. An “ A” indicates the employee was absent from work on that
particular day.
21. The person who worked with the GREATEST number of dogs for the week was
A. Joe
B. Linda
C. Ed
D. Jennifer
22. The person who worked with the LEAST number of dogs for the week was
A. Joe
B. Linda
C. Ed
D. Jennifer
23. The total number of dogs that attended Daisy’s Dog Walking and Daycare for the week was
A. 91
B. 100
C. 101
D. 120
24. Which employee was absent more than once for the week?
A. Joe
B. Bobby
C. Linda
D. Jennifer
25. When the Chief asks you to EXPEDITE a report. What is he asking you to do?
A. Make the report longer.
B. Make the report shorter.
C. Complete the report faster.
D. Check the report for errors.
26. When completing records for a department, it is important to include details which are
PERTINENT? What does this mean?
A. Personal observations.
B. Proven facts.
C. Related to the subject of the report.
D. Briefly summarized.
Answer the following question by reading the paragraph and deciding which statement is
best supported by the paragraph.
27.
Records of certain kinds are of vital importance to every business. Their loss by fire or other
disaster may mean the discontinuance of a growing business, even though other physical
property of the business can be quickly replaced. In general, it can be said that equipment
designed for the protection of records from loss by fire will also be adequate against
burglary.
According to the above paragraph,
A.
equipment that is adequate to protect loss of records from fire is generally useless in
prevention of burglary.
B.
the loss of important records may mean that fire insurance cannot be collected.
C.
the continued existence of a business may be dependent upon preventing the loss of
important records.
D.
business records have, in general, been very inadequately protected from loss by
either fire or burglary.
28. Why is it important to make a positive impression when dealing with the public as a public
employee?
A. If the public is happy with the service received with your department, there will be fewer
calls to the department.
B. Citizens are always more critical of public agencies than they are of privately-owned
businesses.
C. The public will have a more favorable image of a public agency that promptly, efficiently,
and courteously delivers the services that the public expects.
D. Public agencies are much more dependent upon public support than commercial
organizations.
For the following two questions, find the pairs of numbers which are exactly the
same; count the identical pairs you find in each item and then mark the letter on your
answer sheet that corresponds to the total number of identical pairs. A=1, B=2, C=3,
and D=4.
EXAMPLE:
687 --- 687
4265 --- 4265
6898 --- 6897
7490 --- 7480
This example has 2 pairs of matching numbers (687 --- 687 and 4265 --- 4265). Therefore,
the correct answer for this example question is B for 2 correct matching pairs.
29.
456212 --- 456212
89570 --- 89670
5873659 --- 5873659
4126701 --- 4162701
30.
59846 --- 58964
770583 --- 707835
34987 --- 34987
879528 --- 875928
The following questions consist of an original name and address on the left and a copy of
the name and address on the right. You are to check the copy against the original and
record your answers according to the code listed below:
Mark “ A” if there are errors in one line only
Mark “ B” if there are errors in two lines only
Mark “ C” if there are errors in all three lines
Mark “ D” if there are no errors
31. .
ORIGINAL
Kevin R. Daniels, III
709 South Manchester Blvd.
Baton Rouge, LA 70809
COPY
Kevin R. Daniels
709 S. Manchester Blvd.
Baton Rouge, LA 70908
32.
ORIGINAL
Mark Smith
PO Box 4587
Mandeville, LA 70447
COPY
Mark K. Smith
PO Box 4587
Madisonville, LA 70447
Use the following information to answer questions 33 and 34.
Assume that you are paid every week.
Wage per hour = $10.50
Hours worked for the week = 40
Taxes withheld = 20% of gross pay
33. What is the amount of your paycheck before taxes are withheld?
A. $336.00
B. $420.00
C. $450.00
D. $840.00
34. What is the amount of your paycheck after taxes are withheld?
A. $336.00
B. $420.00
C. $450.00
D. $840.00
35. 5.06 added to .007 equals
A. 5.013
B. 5.067
C. 5.13
D. 6.03
PRACTICE EXAM KEY
1.
The correct answer is D.
As a public employee, and representative of the department, you should always try to help
the caller or find someone who can.
2.
The correct Answer is B.
In order to copy a one-sided document so that it becomes a two-sided
document, you must choose one-sided to two-sided.
3.
The correct Answer is C.
“Bcc:” stands for “Blind carbon copy”. You would use this to send the contents of
an email to multiple recipients while maintaining the confidentiality of your
recipients’ email addresses from one another.
4.
The correct answer is B.
According to the telephone directory, the direct line number is 243-6161.
5.
The correct answer is C.
Mandy Thompson is listed as the Nurse Manager for the OR Department.
6.
The correct answer is C.
According to the telephone directory, the fax line number belongs to the Human Resources
Department.
7.
The correct answer is C.
There are 35 Black Ink Pens in inventory.
8.
The correct answer is D.
16G Flash Drives are $5.00/each.
9.
The correct answer is D.
The total cost of the copy paper in inventory is $140.00 ($35.00 per box multiplied by 4
boxes = $140.00)
10.
The correct answer is C.
There are 14 notepads in inventory.
11.
The correct answer is C.
The first name to be filed would be Barbara Johnson.
12.
The correct answer is B.
The cards would be arranged alphabetically by names in the following order: Bartley, Caldwell,
Evans, and Jones.
13.
The correct answer is A.
Chronologically means “in a way that follows the order in which events or records occurred.”
Which means that by date, the cards would be arranged in the following manner: April 5, April
11, April 18, April 23.
14.
The correct answer is A.
The cards are numbered 1, 2, 3, and 4. Therefore, the correct order for the cards to be placed is
1, 2, 3, and 4 which corresponds to cards A, B, C, and D.
15.
The correct answer is B.
The number 5,128 falls in between the numbers 5,101 and 5,200.
16.
The correct answer is B.
The correct order of time is 12:01 p.m., 1:00 p.m., 3:00 p.m., and 11:59 p.m. 12:00 noon begins the
p.m. hours therefore, 12:01 p.m. is the number from the sequence that is earliest in the day.
17.
The correct answer is C.
According to the choices. For choice “A,” the second letter of “breath” is not “e” and the third
letter is not “a”. For choice “B,” the second letter of “breath” is “r”, and the final letter is “h”,
however, the third letter is not an “a”. For choice “C,” The second letter is not an “e”, the third
letter is an “e” which is anything other than a “t”, and the fourth letter is an “a” which is not an “h”.
Since the word “breath” can be categorized by choice “C,” choice “D” would be an incorrect
response.
18.
The correct answer is C.
The correct usage of the words you’re (you are) and your are represented in C.
19.
The correct answer is A.
The correct spelling of the word for this sentence is “write.”
20.
The correct answer is B.
The correct spelling of the word for this sentence is “they’re” which stands for “they are”.
“I think they are going to regret not wearing a jacket today.”
21.
The correct answer is D.
When adding up the number of dogs that each person worked with Monday – Sunday, Jennifer
had the greatest number for the week.
22.
The correct answer is B.
When adding up the number of dogs that each person worked with Monday – Sunday, Linda
had the least number for the week.
23.
The correct answer is D.
After adding all dogs worked with by each person Monday – Sunday. There were a total of 120
dogs at Daisy’s Dog Walking and Daycare for the week.
24.
The correct answer is C.
Linda was the only employee with more than one “A” for absent listed for the week on the
schedule.
25.
The correct answer is C.
The definition of the word expedite is to “make (an action or process) happen sooner or be
accomplished more quickly”.
26.
The correct answer is C.
The definition of the word pertinent is “relevant or applicable to a particular matter”.
27.
The correct answer is C.
According to the passage it is vital to a business to protect records from loss.
28.
The correct answer is C.
Even if the public is happy with your service, they still may call your department many times.
Citizens are critical of public agencies just as they are of privately-owned businesses.
Commercial businesses are just as dependent upon public support to stay in business as public
agencies are. Just as in any organization, public citizens and consumers will always feel more
favorable towards an organization (or public agency) that conducts itself efficiently and with
good customer service.
29.
The correct answer is B.
There are two matching pairs of numbers.
30.
The correct answer is A.
There is only one set of matching numbers.
31.
The correct answer is C.
There are errors in all three lines.
32.
The correct answer is B.
There are errors in two of the lines.
33.
The correct answer is B.
$10.50 X 40 hours = $420.00.
34.
The correct answer is A.
$420.00 Weekly Pay multiplied by 20% (.20) equals $84.00. $420.00 Weekly Pay minus taxes of
$84.00 equals $336.00.
35.
The correct answer is B.
When you line up the decimals and add the numbers 5.06 to .007, the sum is 5.067.
Practice Exam Grading Scale
Items
Missed
Resulting
Score
0
100%
1
97%
2
94%
3
91%
4
89%
5
86%
6
83%
7
80%
8
77%
9
74%
10
71%
11
69%
12
66%
13
63%
14
60%
15
57%
16
54%
17
51%
18
49%
19
46%
20
43%
21
40%
22
37%
23
34%
24
31%
25
29%
26
26%
27
23%
28
20%
29
17%
30
14%
31
11%
32
9%
33
6%
34
3%
35
0%
SCRATCH PAPER
+
NAME:
MAILING ADDRESS:
Include CITY, STATE
and ZIP CODE
EMAIL ADDRESS:
PHONE NUMBER:
