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Perkins Outreach Summer Programs 2015 Please check which program you would like an application for Outreach Summer Employment Program June 28-July 31 2015 11 864 Outreach Elementary Program July 19-July 24 2015 1 000 Computer Science Academy July 26-August 7 2015 7 284 Name Sex DOB Age Grade Address City State Zip Phone Student s E-mail Parent/Guardian E-mail Parent/Guardian Name Day Phone Vision Teacher s Name Phone State Counselor s Name Phone Does student use Braille large print tape reg....
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