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Welcome to
CCMS
Student
Information Form
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| Please complete the form |
| Instructions for filling in the fields are in
green. Optional fields in blue. |
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Student Info |
| Today's
Date |
example:
09/01/2006 |
| Grade |
example: 06 |
| First
Name |
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| Nick Name |
optional |
| Last
Name |
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| Ship |
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| Mom's
Name |
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| Dad's
Name |
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| Home
phone |
example: 123-456-7890 |
Best time to
call
your parents. |
Mornings
Afternoon
evening
anytime
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Days
Available
to attend remedial.
(Check all that
apply)
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Tuesday
Wednesday
Thursday
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| Please indicate
which elementary school you attended. |
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| Writing
sample |
In an
open ended response please tell us about your summer vacation. Describe
how you spent your days, who you were with , where did you
go? |
Please write your response here in
650 words or less including spaces and
characters.
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