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Karen Benson-Form Completion

Re-read the story on Karen Benson. Fill in the blanks for the form using information on Karen Benson.

Personal Information

First Name: ___________________ Family Name: _______________ Middle Initial: ________________

Date of Birth: __________________ Place of Birth: _______________ Marital Status: _______________

Address (Full): ________________________________________________________

City of Residence: ___________________ Province of Residence: __________________________

Gender: _____________ Age: ______________ Years of Schooling: _________________________

Occupation: ____________________ Mother Tongue: _____________________________________

Present Employer: _______________________________________

Story