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CHILD CARE FORM Please complete and return by September 19, 2016, Last Name: First Name: Union/Organization: Local #: Address: City: Province: Postal Code: Tel.# Work: Home#: Cell #: Email: Fax #:

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6. Once you are confident that the form is complete, sign and date it at the designated space.
7. If required, attach any necessary supporting documents or evidence.
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Please complete and return is a document or form that needs to be filled out and sent back to the requesting party, often used for administrative purposes.

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