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Name of School Director or Chief Executive Officer Signature of School Director or Chief Executive Officer Date Part 2. The information reported below applies to: School Director Acting Director Part 3. Name of School: School Address: Phone Number: Permanent School E-Mail Address: Director's Name: Home Address: City PDE-340 (11/07) State 1 of 2 Zip Pennsylvania Department of Education Part 4. Director's Education If you need more space, use an attachment labeled "Qualifica.
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