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Other names you might have used E. Gender Female Male F. Social Security Number Required -- G. Date of Birth Month Day Year H. Mailing Address Street or P. O. Box City State Zip Code I. Home Phone Cell Phone E-mail J. In case of emergency notify Last Name First Name Relationship Area Code Phone Number K. Parent/Guardian Signature A. COURSE ENROLLMENT REQUEST The High School Principal or designee must indicate the college course in which the student has permission to enroll and the...
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