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T Middle School or University Address U.S. Citizen City State Zip Code Permanent Address (not school) City State School Phone Zip Code Permanent Phone Current E-mail Emergency Contact Relationship Emergency Phone Other Phone Professional Experience Undergraduate Degree Graduate Degree (if applicable) Teaching Credential Teaching Assignment 2012 (subject area) Grade Level (6 - 9) Teaching Assignment 2012 (specific) Years Teaching Session I am applying for (first choice) I am.

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