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Student Name
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Parent/Guardian Name
Your answer
Address
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Home Phone
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School Hours Phone
Your answer
E-Mail Address
Your answer
Emergency Contact
Your answer
Transportation to School
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Transportation from School
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Has your student repeated a grade?
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Which grade?
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Does your student have any health concerns?
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Did your student receive special services (AIG, Special Needs, Intervention) last year?
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What would you like your child to accomplish this year?
Your answer
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