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Form #3Screening and Enrollment MONTH: ENROLLMENT YEAR: SITE:#DATE OF CLINIC INITIATE OF SURGERYSUBJECT NAME(mm/dd/yr)(mm/dd/yr)(Last Name, First)Revised: 2/16/2007AGEGENDER(years) Male range of Female
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Begin by accessing the form either online or through the designated office.
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Provide your personal information accurately, including your full name, address, contact number, and any other required details.
03
Fill out the sections related to your background and educational qualifications, ensuring that you indicate any relevant experience or certifications.
04
In the screening section, answer all the questions honestly and thoroughly. These questions may pertain to your health history, criminal record, or any other factors that might affect your eligibility.
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Who needs form 3--screening and enrollment?
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Individuals applying for a specific program or service that requires screening and enrollment may need to fill out form 3.
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Educational institutions or organizations offering educational or specialized services might require individuals to complete this form.
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Employers, especially those in sensitive fields, may request form 3 to ensure the suitability and eligibility of potential employees.
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