FORM 5C - 1965 (1)_____, (2)_____, (3)_____, (4)_____, (5)_____, (6)_____, (7)_____, (8)_____, (9)_____, Joe Templeton [Teacher]. (10)_____, (11)_____, (12)_____, (13)_____, (14)_____, (15)_____, (16)_____, (17)_____.