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Code Relationship to Student Cell/Home Telephone No. Email STUDENT ACADEMIC INFORMATION Name and location of current school attended: School Name *Please enclose a photocopy of your current study permit (if applicable) Location Grade 9 digit BC PEN # (if applicable) Which school(s) would you prefer to attend in Coquitlam? (Please list three in order) 1. Placement in school of choice is not always possi.

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