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* 1. Parent/Guardian Name

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* 2. Parent/Guardian Email Address

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* 3. Phone Number

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* 4. Child's Name

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* 5. Gender

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* 6. Child's Age at Christmas

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* 7. Child's Grade

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* 8. Child's School Teacher Name

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* 9. What time would you like us to call on XXXX?

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* 10. Please choose an additional time.

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* 11. Child's Christmas Gift Requests

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* 12. Please provide some helpful information for the North Pole (e.g, nicknames, birthdays, siblings names, ages, hobbies, pets, etc.)

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* 13. List any good behaviors that you would like the North Pole Callers to compliment your child on.

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* 14. Please list any behaviors that you would like the North Pole Callers to reinforce (e.g., cleaning their room, brushing their teeth, etc.)

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* 15. Is there anything else that the North Pole Helpers need to know?

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