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Non-Public School Name: Public School District of Service: (District where school is located) These are additions/deletions made between 10/15 (Form 1,2,3 report due date) and 12/1. Effective Dates are Required. STUDENT NAME. List Alphabetically. Mark only student’s primary identification Effective Date: Early Childhood. 3-5yr Speech Autism Autism Scholarship Program Jon Peterson Cognitive ... ................
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