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Get Diocese Of San Jose Dsj-cr06 2012-2024

PUPIL RECORD VERIFIED BY/DATE PHONE: 1) ■ YES ☐NO U.S. CITIZEN: ☐ SEVIS (I-20) # 2) ETHNIC HERITAGE: Select 3) FAMILY INFORMATION ADOPTIVE PARENT, STEPPARENT, MOTHER (Natural) FOSTER PARENT, GUARDIAN (If FOSTER PARENT, GUARDIAN (If Applicable) FATHER (Natural) NAME HOME PHONE WORK PHONE ☐ DECEASED ☐ DECEASED VERIFICATION OF HEALTH RECORD ☐ CA SCHOOL IMMUNIZATION RECORD (BLUE CARD) Location/Verified By BAPTISM DATE CHURCH CITY, STATE, COUNTRY VERIFIED BY SACRAMENTAL RECORD.

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