Epstein Secrets

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e either physician documented or parental recall (fork' i year) for school attendance as documented on the reverse side of this form. Physician or Clinic Na Physician or (Print or stamp) Authorized Signatu Add Date: Df~ 1)-3 Certificate of Immunization Supplement for 7th Grade Requirement PART A-2

ng Handwriting/Penmanship Social Studies Science/Health Grades not given this nine week FINE ARTS REPORT Art Music Marking Period 1121EIMES Physical Education PARENT/GUARDIAN/TEACHER CONFERENCE Conference conducted (Indicate date(s)) Marking Period 1st 12nd 3rd 4th Grade (.5 Year 2000-2001 SOCIAL

ve with the 1997/98 school year: tetanus-diphtheria booster, hepatitis B vaccine series, and second dose of measles vaccine as docurn. Physician or Clinic Na Physician or (Print or stamp) horized Signatur Addr• Date: --1 1 St (C)--' . Temporary Medical Exemption PART B (For children in child care

s A a- Aci- ,81" Ertl C Science / 5 5 S *Sri— ,r4 Health 4, a a- a- /7- Music 5. 5 sst- ,..5.4 5 II- ...0-: Art 5 SI- ,54- S )e--- .5/— Physical Education 5 5 -.5' S. C f Promoted or Retained Teacher 2 4, (7‘ EFTA01727105 Elementary Test Record Student CTBS/4 FORM/ LEVEL A-11 GRADE • 1.

e either physician documented or parental recall (fork' i year) for school attendance as documented on the reverse side of this form. Physician or Clinic Na Physician or (Print or stamp) Authorized Signatu Add Date: Df~ 1)-3 Certificate of Immunization Supplement for 7th Grade Requirement PART A-2