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Intake Questionnaire Today's Date: Please Print Students Name: Date of Birth: Age: Parents/Guardians Name: Home Address 1: Grade: street city zip Home Address 2: zip Contact Information: Parent 1:
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What is today's date?
Today's date is June 15, 2021.
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Everyone is required to be aware of and acknowledge today's date.
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Today's date can be filled out by writing the month, day, and year in the designated spaces.
What is the purpose of today's date?
The purpose of today's date is to keep track of time and events.
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Any relevant events, appointments, or milestones that occur on today's date should be reported.
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