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* 1. Student Name (First and Last)

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* 2. Student Age or Grade (2021-2022 School Year)

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* 3. Student Date of Birth

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* 4. Father First and Last Name

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* 5. Father Cell Phone

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* 6. Father eMail

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* 7. Mother First and Last Name

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* 8. Mother Cell Phone

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* 9. Mother Email

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