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Student's Information
First Name
Last Name
Student ID
Address Line 1
Address Line 2
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State
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Date of Birth
Month
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Day
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30
31
Year
1990
1991
1992
1993
1994
1995
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2000
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2002
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2005
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2007
2008
2009
2010
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2025
Age
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West Las Vegas
Las Vegas City Schools
Grade
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Select Grade
K - Kindergarten
1 - First
2 - Second
3 - Third
4 - Fourth
5 - Fifth
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11 - Eleventh
12 - Twelfth
Other
Ethnicity
Hispanic
Caucasian
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Other
Student's Primary Language
English
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Other
Parent/Guardian Name
First Name
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