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PEPPERMINT UNDERGRADUATE HEALTH HISTORY THIS FORM IS REQUIRED FOR REGISTRATION AND ATTENDANCE FAX TO 3105064588 UNIVERSITY Student Health Center PART 1: PERSONAL DATA: To be filled out by student
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How to Fill Out Part 1 Personal Data:

01
Start by carefully reading the instructions provided on the form. Ensure you understand the required information and any specific format or guidelines mentioned.
02
Begin with your full legal name, including your first name, middle name (if applicable), and last name. Avoid using nicknames or abbreviations unless instructed otherwise.
03
Provide your contact details, including your residential address, phone number, and email address. Double-check the accuracy of these details as they may be used for communication purposes.
04
Indicate your date of birth by writing down the day, month, and year in the designated spaces or in the required format. Make sure to use the correct calendar system (e.g., Gregorian) and include any necessary zeros.
05
If applicable, provide your gender or confirm if you prefer not to disclose this information. Some forms may require you to select from multiple options or simply indicate "M" for male or "F" for female.
06
State your citizenship or nationality. Specify the country or countries to which you hold citizenship and include any relevant identification numbers or documents if requested.
07
If required, disclose your Social Security number, national identification number, or any other unique identifying information as indicated on the form.
08
Fill in your marital status, indicating whether you are single, married, divorced, widowed, or in a civil partnership. If applicable, provide the corresponding date of marriage or divorce.
09
If necessary, provide information about your dependents, including their names, dates of birth, and relationship to you. This section might require additional details such as their nationality or Social Security numbers.
10
Finally, review your responses to ensure accuracy and completeness. Correct any mistakes or omissions, and make sure all entries are legible and easily understandable.

Who Needs Part 1 Personal Data:

01
Individuals applying for official documents or services, such as passports, driver's licenses, or government benefits, often need to provide part 1 personal data. These details help establish their identity, citizenship, and eligibility for specific services.
02
Employers and human resources departments typically require part 1 personal data from job applicants or employees to maintain accurate records, process payroll, or facilitate various employment-related processes.
03
Educational institutions, including schools, colleges, and universities, may request part 1 personal data from students for registration purposes, scholarship applications, or maintaining academic records.
04
Government agencies or organizations involved in census surveys, demographic studies, or public health programs may collect part 1 personal data to assess and address population needs.
05
Financial institutions, such as banks or credit unions, usually require part 1 personal data when opening accounts, applying for loans or credit cards, or conducting financial transactions. This information helps verify the customer's identity and assess their creditworthiness.
Overall, part 1 personal data is necessary for various administrative, identification, and verification purposes across different sectors, ensuring smooth processes and compliance with legal requirements.
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Part 1 personal data includes information such as name, address, date of birth, and contact details.
Any individual or entity who is required to submit the specific form requesting part 1 personal data.
Part 1 personal data can be filled out by providing accurate information in the designated fields of the form.
The purpose of part 1 personal data is to verify the identity and personal information of the individual or entity filing the form.
Information such as name, address, date of birth, and contact details must be reported on part 1 personal data.
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