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N: I 117` WAIF U 'CHM. - RANSF.FRRIRC Fun. l. I I. i 115. TAT; LII LAST %IMMO/14M (201 We O 1 t ItVLI •211 LAST P.IBLI: SCHOLL AT Et RUE U IN PALM BE AC‘ LUUN IT 122) DATE ATTENOID FREE OR REDUCED PRICE LUNCH AND HEALTH INFORMATION: (23) NATE YOU FILLED OUT AN APPLICATION FOR F FE I or FEOU:E(I
THE STUDENT A SINGLE PARENT^ Sin _I NO (23) HAS (Do Paid lee this school year in another Florida comfy as verified by receipt a H Paid fee in Pan Beach Count/ as verified by MONO # _..I I Exempt (25) ENTRY CODE: (26) ENTRY DATE: (27) WT DIST. j ADM j ESCL J ESE J MAD (28) TRANSPORTATION:
I PHYSICIAN OR CONIC NAME (PLEASE PRINT) JATELY IMMUNIZED AGAINST 'DANCE. -//,1/2,73 DATE EFTA01710101 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: FLORIDA STATUTES 232.032, a 10D-3.088, F.A.C. and S. 10M-12, F.A.C. ATE PARENT OR GUARDIAN FIRS I MI DOB moinAnta Child's 5Stt (optional) ST
FEAT Raids Caw*Mauva Assossmett Spring 2004 NAME: Florida Comprehensive Assessment Test (FCAT) ID: SCHOOL: NORM-REFERENCED TEST DISTRICT: 50 PALM BEACH Grade 10 Student Report This report shows your results from the FCAT National Nonn-Referenced Test. The FCAT Norm-Referenced Test measures your achi
El Other This page has been updated OV DATE: 4a97 a5- BY: DATE: PBSD 0269 (REV. 1/88) EFTA01709618 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: FLORIDA STATUTES 232.032, s. 10D-3.088, F.A.C. and s. 10M-12, F.A.C. LAST NAME PARENT OR GUARDIAN FIRST MI DOB MCYDAAR Child's SS# (optional)
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Retain Mr Indicate: Promote (P) Retain (R) - Indicate: Promote (P) Retain (A) 01-93d0 EFTA01709793 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: FLORIDA STATUTES 232.032, s. 64D-3.011, F.A.0 and s. 65C-22.006, F.A.C. LAST NAME J PARENT OR GUARDIAN D i r e t t i o n C • Enter all appropri
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be between 1750 and 1856. NT-Not Tested NR-Not Reported Data Run Date: 11/22/2004 0115263 EFTA01710024 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: FLORIDA STATUTES 232.032,8.64D-3.011, F.A.0 ands. 65C-22.00C F.A.C. FIRST Child'sSW (optional) MIAR IM DO MO/DA/YR STATEIMMUNIZATION ID#' Dire
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(46f DATA ENTRY COMPLETED BY DATE S/ DATE PBSD 0636 (REV. 4/6/20015.29/2001) page 2 of 2 EFTA01710389 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: FLORIDA STATUTES 232.032, s. 10D-3.088, F.A.C. and s. 10M-12, F.A.C. LAST NAME PARENT OR GUARDIAN Directions: • Enter all appropriate doses and
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