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Get MI LOOP Program Registration - City Of Grand Rapids 2008-2024

Middle Initial Last Name Home Address Phone # Gender Date of Birth Male Female LOOP Program Site What school does your child attend? CITY ST ZIP Grade Please mark the days your child will be attending the Loop program each week: Monday Tuesday Wednesday Thursday Demographic Data (responses will not affect the applicant s qualification to participate) Child's Ethnicity Family Size Friday Household Income Lunch Status African American Multi-racial 1 2 3 4 5 under $5,000.

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