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Student Information
Student's Legal Last Name *
Student's Legal First Name *
Student's Legal Middle Name *
Birth Date *
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Gender *
Primary Language Spoken at Home *
Birth Country *
Grade for 2020-2021 School Year *
School Transferring From
Date of Original Entry in U.S. School
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Race (check all that apply) *
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Ethnicity (check one) *
Has the student ever received special education services *
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