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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:
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WRITING ca S2 1— ,-. an oa of K Textbook Assessments E) EDL K FCAT Diagnostic I Practice Tests K Diagnostic Software O Other (see attached) n Palm Beach Writes K Portfolio O Performance Assessments K FCAT Diagnostic/Practice Tests K Diagnostic Sothvare O Other (see attached) ro MATHEMATICS Text
ve if additional space needed) C. LABORATORY (as indisated)., Hemoglobin /Hematocrit /cam • -6 NAM TITLE: ADORES (Please Print) Stool (0 & Tuberculin test: Sickle Cell ‘in Date 1ype -Fist date 7 / 34 1f results 9 OH 3040. 10196 (Riableces HRS44 Form 3040 which may ,(Stock Number. 5744-000-3
ICS II SCIENCE 4KTextbook Assessments O EDL JR FCAT Diagnostic/ Practice Tests K Diagnostic Software O Other (see attached) O O O • K O Patin Beach Writes Portfolio Performance Assessments FCAT Diagnostic/Radice Tests Diagnostic Software Other (see attached) Wextbook Assessments O pooso O
s I •• •r aM) (attach narrative if additional space needed) .:• C. LABORATORY (as indicated) • type Hernaglobin/Hematocrit Stool (O & PI Tuberculin lest " results dte Lead Sickle Cell NAME TITLE: ADDR (Pleas. NRS-N (Stock EFTA01709998 .ms 1%3 (344) OFFICE of VITAL STATISTICS CER
Entities connected to both Palm Beach and Tuberculin

Ghislaine Maxwell
PERSON
George W. Bush
PERSONLeon Black
PERSON
Palm Beach County
LOCATIONDoug Band
PERSON
Vicky Ward
PERSON
Harry Reid
PERSON
Earth
LOCATIONOPTIONAL
ORGANIZATIONChemical
ORGANIZATIONHarcourt
LOCATIONTd (Adult) Vaccine
ORGANIZATIONFCAT Mathematics
ORGANIZATIONLegal Authority
ORGANIZATIONUn estudiante del Nivel 5
ORGANIZATIONInforme sobre el FCAT
ORGANIZATIONLos resultados obtenidos
ORGANIZATIONInformes
ORGANIZATIONDescription of Grade 10
ORGANIZATIONThe National Percentile Rank
ORGANIZATION