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Get HI OCISS Form 051 2012-2024

Tion of An Individual As the Parent checklist: 1. The school completes Part A and B and sends the form to the surrogate parent provider. 2. The Surrogate Parent Director/Designee completes Part C and D, retains a copy and returns the original form to the referring school. 3. The school keeps the original in the student’s confidential folder. A. STUDENT DATA Name of Student: ________________________________________ Student I.D. Number: __________________ School: _____________________________.

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