Document Mentions (4 shared documents)

EFTA01709707

2 mentions1 same-page

Page ?Same page

K Early Intervention 0 C. Chapter 1 0 S. Subsidized Child Care 0 O. Other 0 0 If E. is YES, is the parent on active duty? Check service below: 0 Air Force 0 Anny 0 Coast Guard 0 Marines 0 National Guard 0 Navy (IntS DC STUDENT A SINGLE P 0 YES NO ( 8) CURRENT GRADE LEVEL . ey dfrc, • • / I9 NA

14 Form 3040 which easy be used) Mock Plumbot. 5744400.3040-2) Authorized Signature-- Date EFTA01709711 FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: sections 232.032, 402.305, 402.313, Florida Statutes; rules 64D-3.011, 65C-22.006, 65C-20.011, Florida Administrative Code LAST NAME PARENT OR GU

EFTA01710036

2 mentions1 same-page

Page ?Same page

rent is in the uniformed services of the United States. 0 Yes a No If "E" Is YES, Is the parent on active duty? 0 Yes 0 No (check service below) 0 Air Force 0 Army 0 Coast Guard 0 National Guard 0 Navy 0 Marines 2. Preschool Enrollment Information (Check each program attended. Indicate with an aste

TY MIAMI FL 33188.0001 NEW Charges Past Due Total Now Due AUG 21 2003 $228.20 EFTA01710059 • • I' FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: sections 232.032, 402.305, 402.313, Florida Statutes; rules 640-3.011.65C-22.006, 65C-20.01I, Florida Administrative Code LAST NAME PARENT OR GUA

EFTA01710219

2 mentions1 same-page

Page ?Same page

K Early Intervention 0 C. Chapter 1 0 S. Subsidized Child Care 0 O. Other 0 0 If E. is YES, is the parent on active duty? Check service below: 0 Air Force • Army 0 Coast Guard 0 Marines 0 National Guard 0 Navy (17) ISIHE STUDENT A SNORE PARENT? NO 0 YES 0 NO Om CURRENT GRADE LEVEL 07 4TRANSEEWI

FLORIDA CERTIFICATION OF IMMUNIZATION Legal Authority: sections 232.03Z, 402.305, 402.313, Florida Statutes; rules 640-3.011, 65C-22.006, 65C-20.011, Florida Administrative Code LAST N FIRST NAME MI