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La43203
La43203
Candidate Data:
First Name:
Alexander
Last Name:
Lamarre
Date of Birth:
Age:
10
-
01
-
10
School:
Beaver Meadow School
Grade:
4
Guardian Info:
First Name:
Ashley
Last Name:
Address:
Concord
NH
03301
Guardian/Family Phone:
Guardian/Family Email Address:
Living Situation:
Mother w/ live-in boyfriend
Financial Situation:
Medicaid:
Free/Reduced Lunch:
TANF:
SNAP:
How many live in the household?
0
How many work and/or provide income to support the household?
0
Household Situation:
Organizations / Mentor Programs:
Special Assistance:
Health Concerns:
Victim of Sexual Abuse:
Perpetrator of Sexual Abuse:
Victim of Physical Abuse:
Threatening or Aggressive Behavior:
Required Physical Restraint:
Personality / Social Standing:
Behavioral Patterns:
Remarks: