Epstein Secrets

RIGIN M 0 I-American Indian/Alaskan Native 0 8-Black. Non-Hispanic 0 H-Hispanic 0 A-Asian/Pacific Is

ing the school day? .0 YES 0 NO If YES, provide the school with a copy of the court order. PESO 0636 (REV. 5/29/2001) page 1 of 2 EFTA01709611 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION (36) FATHER OR LEGAL GUARDAN first rmcWe Hap SAD IIIIIII IIIII PU: Y giimOR4211 OR LEGAL GUARDIAN (last mAMM

10) F 1 (11)RACFJETHMC ORIGIN y • Native 0 B-Black, Non-Hispanic 0 H-Hispanic 0 W-White, Non-Hispan

the school day? O YES .NO If YES, provide the school with a copy of the court order. - ' PBSD 0636 (REV. 4/6/2001) page 1 of 2 EFTA01709714 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION (36) FATHER OR LEGAL GUARDIAN 031st mkIdle Alia( Ms° (37 ADDRESS (SOW nomboS 7-4" 94 4:1311Tvnlixdpber) IIIIIII

er II I - American Indlan/Alaslcan Native D B - Black, Non-Hispanic 0 H - Hispanic 0 W - White, Non-H

dent during the school day? U YES Wil0 provide the sotto& with a copy of the court order. PBSD 0636 (REV. 02/04/2002) page t o12 EFTA01710055 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION v - ! -. an k C A- t STATE ZIP COCE pa d 6. FL d3V I1 On l0Jtii Palm STATE ZIP CODE PL 334 1 ' 0OCU

SEX: RACIAL/ETHNIC GROUP: G Mao Not Hispanic G Black Not Hispania -c Dale First Entered This ()kirk'

ng the school day? O YES NO If YES, provide the school with a copy of the court order. • PBSD 0636 (Rev. 03/19/2003) page 1 of 2 EFTA01710230 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGIS 1 ) FATHER CR LEGAL GUARDIAN (Sat 77404 int.9. 7779 (34) DATE OF BIRTH (45) DATE OF BIRTH 5 - • Oa - (.0 7 DO ADD

er II I - American IndlaniAlaslcan Native D B - Black, Non-Hispanic 0 H - Hispanic 0 iiv - White. Non

dent during the school day? U YES Wil0 provide the sotto& with a copy of the court order. PBSD 0636 (REV. 02/04/2002) page t o12 EFTA01727108 THE SCHOOL DISTRICT OF PALM BEACH COUNTY - NEW AND RETURNING STUDENT REGISTRATION I I- an - kOODUP eVitt Palm STATE ZIP COCE bud', FL 83Y 1 L CITY ..„ al m iatieeh a STATE ZIP COD