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SHV Extra Day Request Form 
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Email *
Student Last Name: *
Student First & Middle Name *
Extra Day Request Date: *
MM
/
DD
/
YYYY
Check Student Class: ($70.00 Fee) *
Required
Payment Choice: *
Required
Payment By Check - Provide Check #
Parent/Guardian Signature: *
Date Submitted: *
MM
/
DD
/
YYYY
A copy of your responses will be emailed to the address you provided.
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