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Application
Application
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Guardian/Parents: Please provide full name and address (if different)
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School District the student lives in:
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Please provide the most recent year of the students last IEP:
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Please provide the most recent year of the students Psychological Evaluation"
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Please indicate the diagnosis(es) determined by a certified professional
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Autism
ADD/HD
Cerebral Palsy
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Down Syndrome
Fragile X Syndrome
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Is the student Catholic?
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Does the student require a one-on-one support?
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PCA
TSS
Nurse
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Please list the students current medications.
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How did you hear about Our Lady of Confidence?
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