Epstein Secrets

VIDUALLY OR IN GROUPS. WEER I NO (261 SODIUM MUORIOt: • ur run vn PWNW An IN THE SODIUM FLUORIDE PROGRAM WM NO EFTA01709936 BACK TRICE or PALM BEACH COUNTY - NEW/RETURNING STUDENTS REGISTRATION DOI STUD [If 4(1 WEE WITH ICKES& I OOHS PARENTS 0 MOTHER 9 TAHITI. 0 SHARED CUSTODY . 7; OTHER • WI T

V (IS) NAME OF SCHOOL TRANSFERRING FROM (20) CITY OR LOCATION (21) LAST ArrEiroANCE DATE (22) LAST GRADE LEVEL (23) LAST PUSUC SCHOOL ATTENDED IN PALM BEACHCOUNTY (24) DATE ATTENDED IN PBC MW4PAggN14041a0AVAlticiN , FREE OR REDUCED (25) Students will receive non-invasive heath screenings pursuant to Florid

inical reasoning or evidence for exemption: DOE Code 3 I cestift that the physical condition of this child Lt nth that immenitatiomNat indicated in Pan C above is medically caltraindicated. Physician or Clinic Name: (flint or stamp) Address: D44 610, 1196. dada= la (4Omo (SIM Maher 574.11O:MX1106)

DEACIE I L I 4)9$ DO SOMETHING - VOTE I Ind ul US. POMACE LAID VArM Palm Rennel %JOANN 164 RETURN SERVICE REQUESTED VOTER IDENTIRCATI0N PAl FA BEACH COUNTY. FLORIDA AIMMItAllOviamER INOTTUSIOROMT OSiI0/01 ROYAL IMACSICI 0 A 14 YOURPRECINCT ImeARER YOUR OOLONG LOCATION IS, PRESENT 1111$ CARO AT Y

nical reasoning or evidence for exemption: DOE Code 3 I cent& that the physical condition of this child is such that immunizations) as indicated in Pan C above is medically contraindicated. Physician or Clinic Name: (Print or stamp) Physician Signature: Address: DII 450, Pd2000, obsoletes whet

when is row( e Sena and the cost & my :hols education is occupied as ny residence. provded in part Dr Melly by Federal subsidy. J H Pad fee in Palm Beam County as velsec by Q C Have filed a mailestation cf domicile in lbs wave OF Am a migratory agricultural worker. Montt _.. _ J I Exempt (25) ENTRY C

nical reasoning or evidence for exemption. DOE Code 3 1 cent that the physical condition of this child is such that immunization(s) as indicated in Pan C above is medically contraindicated. Physician or Clinic Name: (Print or stamp) Physician Signature: Address: DH 680, 8/2000, obsoktm tallitt