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Lephone number Subject Taught Social security number SU, REG, CPT, PPT, OPD License (circle one of the above) CPR/AED Certified 1. Position (s) applied for: Supervisor/Teacher in Charge Teacher of Physical Education Teacher of Arts & Crafts Teacher of Swimming (be sure to complete #9) Teacher of Game Room Yes (Attach copy of certificate) No 2. Program Component Applied for (Indicate 1st,.

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