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1. STUDENT CODE

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2. Please enter date of birth

Date of Birth

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3. Gender

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4. Who do you live with most of the time? (Pick only one)

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5. Are you Hispanic or Latino?

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6. What is your race? (SELECT ONE OR MORE)

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7. What grade are you in?

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8. About how many days were you absent from school last year? (Pick only one)

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9. What grades do you generally get in school? (Pick only one)

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