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Mulberry House A P P L I C AT I O N F O R A D M I S S I O Child Name: ___ Nickname: ___ Birth date: ___ Age as of September 1, 2022: ___ Sex: ___ Home Address: ___ Apartment: ___ City: ___ State:
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Start by writing the day of the month you were born in the first box.
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Move on to writing the month you were born in the second box.
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Finally, enter the year you were born in the last box.

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Birth date age is a record of an individual's date of birth and age.
Individuals are required to provide their birth date and age on official documents.
You can fill out birth date and age by writing down the date of birth and the age of the individual.
The purpose of recording birth date and age is to establish the identity and age of an individual.
The birth date and age of the individual must be reported on birth date age records.
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