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Get SC DSS 2900 2007

Ach child at the time of enrollment in the child care facility, updated annually thereafter, and maintained on file at the facility. GENERAL INFORMATION: (to be completed by Parent or Guardian) Name of Facility: Address: County: City, State, Zip Street Address – no Post Office Boxes Child’s Name: Last First Middle Initial Date of Birth: Nick Name Enrollment Date: Child’s Current Home Address: Street Address City, State, Zip Parent/Guardian’s Full Name: Home Phone: Work Phon.

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