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Ity: Home Phone: Cell Phone: Day Resident Birth Date: State: Zip: Original date entered LMK: / / Social Security #: Identifying Marks: Hair Color: Eye Color: Height: Weight: Significant Medical Conditions: Birthplace: Race: Primary Language: Citizenship: PARENT INFORMATION Father s full name: Check if deceased: Address (if different from student): City: State: Zip: Birth Date: / Home Phone: Cell Phone: Fax: Marital status (circle one) / Email: Birthplace.

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Keywords relevant to Student Information Form

  • custodial
  • Sep
  • Birthplace
  • Dev
  • landmark
  • citizenship
  • Restrictions
  • VISITATION
  • identifying
  • placement
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