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Me: Enter the last name of the pupil for whom this Certificate is being completed. Pupil s First Name: Enter the first name of the pupil for whom this Certificate is being completed. Initial: Enter middle initial of pupil for whom this Certificate is being completed. Name of School: Enter name of school this pupil attends. Parent s Name: Enter the name of the mother and/or father if living with the parents. Otherwise enter the name of the guardian or other person legally responsible for the.

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  • ofcial
  • 30-day
  • III
  • IMMUNIZATIONS
  • Immunization
  • informational
  • Certification
  • exemption
  • Pursuant
  • enrollment
  • Vaccines
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