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If below 18 years old, or physically/mentally incapacitated, the guardian is requested to fill out this form on behalf of the individual/client. I. Purpose of Testing (Please check only one box) Personal Yes No Employment Local Yes No Abroad Yes No Legal/Insurance Yes No Entrance to School Yes No If others, Please specify: II. Demographics (Please fill up all information asked:) First Name MI Last name Permanent address/mailing address:.
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