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- Grade Applying for:*
- Applying for:
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- Student Gender *
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- Race*
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- Has the applicant previously attended another school?
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Format: (000) 000-0000.
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- Has the applicant previously attended any other school?
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Format: (000) 000-0000.
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- Has the student ever been subject to major disciplinary action (suspension or dismissal) in any school?*
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- Has this student applied for admission at Golden Hills School previously?*
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- Please indicate if the applicant has ever been evaluated for the following?
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- Have there have been any situations in the applicant’s life that the school should know about in order to meet his/her learning or developmental needs (i.e.frequent moves, frequent changes of school, death in the family, divorce, etc.)?*
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Format: (000) 000-0000.
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- Gender*
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- Custodial Rights?*
- Financial Responsibility?*
- Receive Correspondence?*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Gender*
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- Custodial Rights?*
- Financial Responsibility?*
- Receive Correspondence?*
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Are there grandparents related to the applicant?
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Format: (000) 000-0000.
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- Gender
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Format: (000) 000-0000.
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- Gender
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Format: (000) 000-0000.
- Is there another set of grandparents related to the applicant?
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Format: (000) 000-0000.
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- Gender
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Format: (000) 000-0000.
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- Gender
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Format: (000) 000-0000.
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- Does the applicant have a parent/guardian that lives at another address?
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Format: (000) 000-0000.
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- Gender
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- Custodial Rights?
- Financial Responsibility?
- Receive Correspondence?
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Gender
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- Custodial Rights?
- Financial Responsibility?
- Receive Correspondence?
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Are there grandparents related to the applicant?
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Format: (000) 000-0000.
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- Gender*
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Format: (000) 000-0000.
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- Gender
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Format: (000) 000-0000.
- Is there another set of grandparents related to the applicant?
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Format: (000) 000-0000.
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- Gender*
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Format: (000) 000-0000.
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- Gender
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Format: (000) 000-0000.
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- Emergency Contacts
- Add Another Emergency Contact ?
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Format: (000) 000-0000.
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- Add Another Emergency Contact ?
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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Format: (000) 000-0000.
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- Permission To Treat
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- Does the applicant take any prescribed medication?*
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- Should be Empty: