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Daily PreScreen
IF YOUR FORM DOES NOT GO THRU PLEASE CALL OR TEXT 413-822-5310. Please have this form completed 30 minutes prior to your child's pick-up time EVERY DAY. Any questions, please call 413-822-5310.
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Date
*
MM
/
DD
/
YYYY
Child's Name
*
Your answer
The phone number I can be reached at today is
*
Your answer
I need transportation for my child in the
*
BOTH AM and PM
AM ONLY
PM ONLY
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