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Booster To Belts Program Completion Form

Thanks for completing the Booster to Belts program in your community!


Please fill out the form below and send pictures of team completing the Booster to Belts program to ktsro@dccca.org. Once both of these steps are complete, KTSRO will process your reimbursement.  KTSRO will need a copy of your W9 before payment will be made.

 Haven’t completed the Booster to Belts program yet? Go HERE to apply!

Your Contact Information
Completion Information
Date(s) Completed:




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