Name:	Benton-Carroll-Salem Local School District
Real Party In Interest:
Type of industry:	education
Address:	11685 West State Route 163
Address 2:
City:	Oak Harbor
State:	OH
Zip Code:	43449
Contact Person:	Cajon Keeton
Phone:	419-898-6210
E-Mail:	ckeeton@bcssd.com

III. Brief description of the type of legislation to which the Legislative Agent's engagement relates:
Legislation which would have an impact on the interest of the employer
IV. Categorical listing of principal business or activity of Employer:
-Education
V. I am a state employee/officer registering on behalf of my public agency, other than an institution of higher education:
NOT CHECKED