Epstein Secrets

Lake Central Elementary School Academic Record — Name Birth Cm Birth / / BANb sz"LlnYoli5r947r7"-='-' COMPUTER FRENCH HEALTH HOME EC. LANG ARTS LIT MATH SCIENCE SOCIAL STUDIES A 0.250 : TOTALW 0.250: • 7.000 D.250 • Rank in Class of 0.250 88 / 300 1.000 ' Absence Tardies • 1.0

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

81 CURRENT SCHOOL: IMODUREVIT GRADE: 03 SCHL TRH COURSE TITLE SP EP ROOM 1 2 3 4 FGECAB SCHL TRH COURSE TITLE SP BP ROAN 1 2 3 4 FGEC AB 5101 A LANG ARTS 0051 5101 A READING 0051 5101 A MATHMATIC 0051 5101 A SCIENCE 0051 5101 A SOC STUDY 0051 5101 A ART 51 5101 A MUSIC 51 5101 A PHIS ED

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

Lake Central Elementary School Academic Record — Name Birth Cm Birth / / BANb sz"LlnYoli5r947r7"-='-' COMPUTER FRENCH HEALTH HOME EC. LANG ARTS LIT MATH SCIENCE SOCIAL STUDIES A 0.250 : TOTALW 0.250: • 7.000 D.250 • Rank in Class of 0.250 88 / 300 1.000 ' Absence Tardies • 1.0

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