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ON FORM INSTRUCTIONS AND IMPORTANT INFORMATION: This form must be completed and submitted within 10 business days of termination of supervision, change in time base or at the end of your expe rience. Full-time and part-time experience can not be combined on the same form. If you are working in a public school you will be required to submit a separate verification form for each school year. You must also provide a calendar for each school year. If you work during the summer you will be required.

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