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Part D Part A PLEASE KEEP A COPY OF THIS FORM FOR YOUR RECORDS THIS FORM MUST BE COMPLETED AND SUBMITTED TO THE HEALTH SERVICES CENTER PRIOR TO THE FIRST DAY OF CLASSES REQUIRED IMMUNIZATIONS MENINGOCOCCAL

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4. Make sure to fill in all the required fields accurately and honestly. Double-check your answers before proceeding to ensure accuracy.
5. If there are any sections that are not applicable to you, write "N/A" or "Not Applicable" to indicate that they do not apply in your case.
6. Pay attention to any specific formatting requirements, such as using uppercase letters for certain fields or providing dates in a specific format.
7. Review the completed form once again to ensure that all the necessary information has been provided. If possible, have someone else review it as well to catch any errors or missing information.

Who needs this form:

1. Individuals applying for a job, internship, or any other type of employment opportunity might need to fill out this form.
2. Students applying for admission to a college or university may be required to complete this form as part of their application process.
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In summary, filling out this form requires careful attention to detail, following the provided instructions, and providing accurate information. The form may be needed by individuals applying for various purposes such as employment or education.

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The purpose of this form is to report income to the IRS.

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Income, deductions, and credits must be reported on this form.

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