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Name Name of person submitting request
Date of request Date you are submitting this form
Location Room number or location
Students Does the work need to be done without students in the area?
Time If yes to the above question, when is a good time?
Date What is an approximate date this request needs to be completed
Explanation Explanation of work needed
The Refugio Independent School District is committed to providing an appropriate learning experience for every child in the district, designed to motivate and assist each child in the attainment of his or her maximum potential intellectually, physically, socially, economically, and morally.

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