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Nixon-Smiley CISD - School Health Advisory Council (SHAC) Interest Form
If you are interested in serving on the SHAC Committee, or would like more information,
please complete the form.
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First Name
*
Your answer
Last Name
*
Your answer
Child's Name - Last Name, First Name
*
Your answer
Child's Grade
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Choose
PK
K
1
2
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4
5
6
7
8
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10
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Other
Additional Child(ren) - Last Name, First Name & Grade
Your answer
Your Prefered Phone Number
*
Your answer
Your Prefered Email Address
*
Your answer
Comments
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