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Child/Youth information (2021-2022)
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* Indicates required question
FULL Name
*
Your answer
DOB
*
MM
/
DD
/
YYYY
School Grade
*
Not in School
Pre-K
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
FULL Address (Street, Town, State, ZIP)
*
Your answer
Parent/Guardian 1 Name
*
Your answer
Phone number (Parent/Guardian 1)
*
Your answer
Confirm Phone number (Parent/Guardian 1)
*
Your answer
Email Parent/Guardian 1
*
Your answer
Confirm Email Parent/Guardian 1
*
Your answer
Parent/Guardian 2 Name
Your answer
Phone number (Parent/Guardian 2)
Your answer
Confirm Phone number (Parent/Guardian 2)
Your answer
Email Parent/Guardian 2
Your answer
Confirm Email Parent/Guardian 2
Your answer
Family Constellation (Who child/youth lives with?)
*
Your answer
Has the Participant attended any Spiritist Education before?
*
Yes
No
If Yes, Where? and for How Long?
Your answer
What is the primary language at home?
*
English
Portuguese
Other:
Please share something else about your child/youth (likes, dislikes, strengths, weaknesses, etc...)
*
Your answer
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