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Household Income Verification Form20172018 State Public Charter School Authority
Complete one application per household. Please use a pen (not a pencil). Child's First NameMIChilds Last NameStudent?
Yes
NoGradeChildren
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Eligible for support includes individuals or organizations who meet specific criteria set by the support program.
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Information such as income, employment status, family size, and any other relevant details may need to be reported for eligibility.
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