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E.P. or an I. CE.P. Please indicate the type of special education services your child is or has received Parent/Guardian Information Father s Name Residence Birthplace Religion Years Attended School Occupation Home Cell Work Mother s Maiden Name Residence Parent Status Married/Living Together Child Lives With Mother and Father Separated Divorced Mother Father Deceased Other If other please explain Student Ethnicity For statistical purposes please indicate your child s ethnicity...
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