Directory Results for 2016 2017 Displaced Student Applicant Verification Date Name of Child(ren): Child # 1 First Middle Last Child # 2 First Middle Last Child # 3 First Middle Last DOB (mm/dd/yyyy) M/F SSN child #1 DOB (mm/dd/yyyy) M/F prev SSN SSN child to 2016 2017 DISTRICT #113 DHS ATHLETICS PERMIT CARD Student ID # PLEASE PRINT IN INK ***This required is due in the Athletics Office yearly prior to the first day of practice *** Last Name First Name Date Address City Male Date of Birth