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FAITH COMMUNITY EDUCATIONAL INSTITUTE Adult Educational Program 1065 N. Van Dyke Decatur IL 62522 217/848-6333 office 217/876-9330 fax www. fca-decatur. org Term A 20 APPLICATION Instructions Fill out this application completely. Print clearly. Be sure to sign this application and attach a photo identification is required prior to acceptance into the program* Current Date Name Residential Address CityStateZipPhone Emergency Name Phone Employed YesNo Name of Company SingleMarriedDivorced...
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