STATE ZIP CODE (64) CITY STATE ZIP CODE (98) RELATIONSHIP OTHER (80) TELEPHONE (61) CS.UPAGER NUMBER (65) RELATIONSHIP (66)1ELEPHDNE (67) CGLUPACIER NUMBER (86) STUDENTS ALE RGES (chick all Mel applyand specify) 0 Birds 0 Reptiles 0 Amphibians 0 Plants 0 Food 0 Other Specify 0 Ncne • Animals