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JORDAN'S PRINCIPLE REQUEST FORM

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The document is a request form for Jordan's Principle, intended for use by parents, guardians, or authorized representatives to seek health, social, or educational assistance for children. It includes sections for child and parent/guardian information, details about the unmet needs of the child, and a declaration of accuracy regarding the information provided. The form emphasizes the importance of immediate care in emergencies and outlines privacy protections for personal information.

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