EFTA01247282.pdf

STUDENT CASE MANAGEMENT SCHOOL NO 9 / STUDENT SERVICES FORM COMPUTER RECORDED EMPLOYEE NO 6 8 J EMPLOYEE NAME S/ 1. 04 / 7-S SERVICE STUDENT NAME CA/SECT SCM# DATE TIME CODE STUDENT ID Mo. Day Yr. (Military/ Ig1T 3 /01 Ot r7S/ Kee- COMMENTS: a2-25/ r-g 1,)lam.ceCvi // I /2-IV Hay 3 19 198 /1:eo 3 747 /2.4 o3 c7SP //X 3 04 O/ 1/1( /5706 o2- Ry Z(30 /1 I o'fQ rev C. REFERRED BY: // I -13 °tote V 878.2184 WitiE - for 04[4:irgr..a4 .r.1„tia in;I14: :00;:gols ofittr . ; ,1141.Z. To AdanNlralor FM-3673 REV. (04-87) COMMENTS: c -e = D— //0 2 - 27e7ice-, 414t-e eon c~1 Gyp Cdej, fT/2 - /4-urrzta-) - , 566:_ef aiA/a4-€ fir) Ictir 7 z 3. ni?e- 11-1)64,1 i/tice,,, (;77-ea 2 /erflnrcee-el , /4,-;.?17 CS7s 878.2164 01011E• for °'''InZ,°.'1:647.0,Irnr;="141,ct";.7.1=1::r10•TO "°"-- FM.3673 REV. (04-87) 3501.160-080 CONFIDENTIAL Page I of I EFTA 00069571 EFTA01247282