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Appendix B: Minnesota Test of Academic Skills (MTA) Data Collection Form Student Name (last, first, MI): ___ MASS/SSID: ___ Date of Birth (mm/dd/YYY): ___Grade: ___ Test Administrator: ___ District:

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Eligibility requirements for the form include meeting certain criteria such as age, income level, and residency status.

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Individuals who are seeking to avail certain benefits or services need to file eligibility requirements for form.

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The purpose of eligibility requirements for form is to determine if an individual is eligible for specific benefits or services.

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