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LVNS Application Form
Email address *
Child's Name *
Your answer
Child's Date of Birth *
MM
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DD
/
YYYY
Child's Gender *
Indicate your program of interest(check all that apply) *
Required
Name and ages of siblings who have attended LVNS and which program attended (morning or afternoon school):
Your answer
Child’s ethnic identity
Primary Home Address *
Your answer
Parent 1 Name *
Your answer
Parent 1 Telephone Number *
Your answer
Parent 1 Email *
Your answer
Parent 2 Name
Your answer
Parent 2 Telephone Number
Your answer
Parent 2 Email
Your answer
Child’s special needs (Please indicate if your child requires special educational attention because of conditions such as physical, learning, speech, or visual handicaps; emotional or behavioral difficulties; chronic health impairment; allergies)
Your answer
A copy of your responses will be emailed to the address you provided.
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