Epstein Secrets

IST YOLR DOW'S ILLNESSES. A.LERGiEs OR OTHER PHYSICAL LMITATIONS YOUR CHILDREN IN OTHER CHOOLS: :Ill NAME OF CHILD SCHOOL ATTENDING STUDENT NO. (OPTIONAL) GRADE OATH DATE tl 4IN — STUDENT NO. (OPTIONAL) GRADE 1531 NAME OF CHILD SCNOOI ATTENOING STUDENT NO. (OPTIONAL) GRADE BRIM DAVE 1641 NA

Tardies O Check Homework O Encourage Reading at Home O Reinforce Skills O Attend Parent Conferences O Sign Daily/ treekly Notes K Attend Parent Curriculum/ Information Meetings 681 (REV. 8/12/2003) ORIGINAL - Cumulative Folder COPY • Te SIGMA! ant 0. r'AlteNT IGWNQAN er r-• •aren ua wan [Alt EFTA01709800 Studer! l

SPITAL PROT:ROME 1501 LIST YOUR CHILD'S ILLNESSES, ALLERGIES OR OTHER PHYSICAL LIMITATIONS: aff 16I/ NAME OF CHILD SCHOOL ATTENDING STUDENT NO. (OPTIONAL) GRADE MATH OATE MI NAME OF CHILD SCHOOL ATTENDING STUDENT NO, (OPTIONAL) GRADE BIRTH DATE (53) NAME OF CHILD SCHOOL ArtFt.01M1Cr STUDENT N

Tardies O Check Homework O Read with Child Every Night O Reinforce Skills O Attend Parent Conferences O Sign Daily/Weekly Notes K Attend Parent Curriculum/ Information Meetings DATE SIGNATURE OF PARENT / GUAR0fAN SIGNATURE OF TEACHER PBSD 1687 (REV. 9/13/2002) ORIGINAL - Cumulative Folder COPY - Teacher COPY Parent/Gua

S, ALLERGIES OR OTHER PHYSICAL LIMITATIONS: A) 0 lie 0007,110- cg, p'Airiel eiTeci , 1511 NAME OF CHILD Aiorc • SCHOOL ATTENDING STUDENT NO. (OPTIONAL) GRADE RIM DATE 1521 NAME Of CHILD SCHOOL ATTENDING STUDENT NO, (OPTIONAL) GRACIE BIRTH DATE (531 NAVE OF CHILD SCHOOL ATTENDING STUDENT NO

Tardies O Check Homework O Read with Child Every Night O Reinforce Skills O Attend Parent Conferences O Sign DailyNVeekly Notes O Attend Parent Curriculum/ Information Meetings DATE SIM 1523-n03 SIGNATURE OF TEACHER OATS PBSD teeT (REV. 9/13/2002) ORIGINAL - Cumulative Folder COPY - Teach 3/4/ EFTA01709981 THE SCHO

GRACE BIRTH DATE 154) NAME OF GILD SCHOOL ATTENDING STUCENT NO (OPTIONAL) GRACE BIRTH DATE (55) NAME OF CHID SCHOOL AT HEADING STUCENT NO. (OPTIONAL) GRACE SIREN DATE ISO) I VERIFY THAT THE INFORMATION GIVEN IS TRUE AND ACCURATE TO THE BEST CF MT KNOWLEDGE. SIGNATURE OF PARENT OR AGE( GjAROIA

ment/Contribution Check as that appiy D Monitor Attendance / 'rarefies EI Read with Child Every Night O Attend Parent Conferences O Attend Parent Curriculum/ Information Meetings O Check Homework O Reinforce Skills O Sign Daily/Weekly Notes GNATCR£ OF PARENT/ GUARDIAN DATE SIGNATLPE OF PEIS0 1697 (REV. 9/11/20021 ORIGI

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Itment/ContributIon Check all that appty. O Monitor Attendance / Tardles K Encourage Reading at Home O Attend Parent Conferences K Attend Parent Curriculum/ Information Meetings K Successfuly Remediated O Requires New AIP Next School Year O Successfully Remediated O Requires New AIP Next School Yew 1171S111/121SIIIINCE