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orbeon pta-remittance Orbeon Demo: Springfield PTA Remittance Form This is a remittance form for the Springfield PTA Council. /fr/service/persistence/crud/orbeon/builder/data/21f5689171e2204b75d8e54becf0c6fa9ce8ac85/ebf0f47edaff6cab6fab79000363b07f4c6b3338.bin { "inline" : true, "hidden_input" : false, "language" : "en", "statusbar" : false, "menubar" : false, "plugins" : "lists link", "toolbar" : "bold italic | bullist numlist outdent indent | link", "browser_spellcheck" : true, "encoding" : "xml", "entity_encoding" : "raw", "forced_root_block" : "div", "visual_table_class" : "fr-tinymce-table", "skin" : false, "convert_urls" : false, "sandbox_iframes" : true, "convert_unsafe_embeds": true }

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Orbeon Demo: Springfield PTA Remittance Form

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(555) 555-5555 Missing or incorrect value
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Date Submitted Missing or incorrect value
Check # Missing or incorrect value

Per Capita Dues (due monthly)
Members Count Missing or incorrect value
Fee per Member $
Member Dues $
One time annual Council Dues (due 11/1)
Annual Dues $
Annual Council Dues $
Donation (optional)
$
Total Check Amount $
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21f5689171e2204b75d8e54becf0c6fa9ce8ac85
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