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Providentcharterschool.org 1400 Troy Hill Road Pittsburgh PA 15212 III. Parent/Guardian Information Both Child Lives With Parents Legal Guardian Special Custodial Court Instructions If Yes Please Provide a Copy of Court Order. Both Parents Alternately Foster Mother Only Other Adult Father Complete Parent/Guardian Name and Address Information As Applicable Parent 1 Name If The Student Is Not Living With Parents Please Complete This Section. Guardian s Name Or Foster Parent s Name My signature...
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