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Get CA Los Angeles Unified School District Volunteer Assistant Coach Application 2007-2024

Eceived (Required) Yes No Date of Skin Test or X-Ray: Day Year Month Date of passing Coaching Education Class (required beginning 1/1/09) Date of CPR/First Aid Verification Administrator in Charge of Athletics SIGNATURE Please PRINT or TYPE the following information and return to: Administrator in Charge of Athletics SCHOOL Last Name First Name Address City Zip Code Phone Bus. Phone Birth Da.

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