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Foster family home, and court-specified home in the County of Los Angeles. Youth living with parents, relatives and extended family members including ASFA (Adoption and Safe Families Act) approved homes are not eligible for these services. Section I - Student Information NAME OF STUDENT (LAST NAME, FIRST NAME, MIDDLE NAME) GENDER DATE OF BIRTH MONTH Male YEAR Female ETHNICITY: White AGE DAY PRIMARY LANGUAGE Hispanic African American SCHOOL CURRENTLY ATTENDING Asian/Pacific Islande.
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