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FORM A Valley Behavioral Health Carmen B. Pingree Autism Center of Learning 2016-2017 School Year Application for Placement and Financial Assistance Application Please be sure to initial that all of the following are included prior to submitting the application 1. Pingree Center Autism Center of Learning. I/we additionally agree to provide the listed information above at the time of application. Furthermore I/we authorize any required verification including a credit bureau report. If yes how...
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Carmen B is a financial disclosure form that must be filed by certain individuals.
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