Parent/Guardian Information

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Student Name *

Please type the name of the student associated with this information.

First Parent/Guardian Name *

Please type your name.

At what phone number can you be reached during the day? *

Is there another phone number that could be used to reach you?

Please type the additional number here.

Email Address

If you have an email address that may be used to contact you, please type it here.

Would you like to receive eNewsletters at this address about what is happening in this course?

Yes

Clear selection

Email Address 2

If you have an additional email address that may be used to contact you, please type it here.

Would you like to receive eNewsletters at this address about what is happening in this course?

Yes

Clear selection

Second Parent/Guardian Name

If there is an additional Parent/Guardian who may be contacted about the student, please provide that person's name here.

Second Parent/Guardian's Phone Number

At what phone number can this person be reached during the day?

Second Parent/Guardian's Email Address

If this person has an email address that may be used for contact, please type it here.

Would you like to receive eNewsletters at this address about what is happening in this course?

Yes

Clear selection

Does the student have access to the Internet at home? *

Yes

Does the student already have access to Microsoft Word at home? *

Yes

Are you aware that Cobb County School District has provided you with a FREE download of Microsoft Office 2013? *

There is a link to get information and download Microsoft Office on my blog.

Yes

Do you have access to Synergy so that you may check student grades? *

Please come by the school to get online access to student grades.

Yes

Do you check Synergy on a regular basis? *

Checking Synergy regularly is the BEST way to keep up-to-date on student progress.

Yes

Does your student have a cell phone with Internet access? *

Yes

Does your student have your permission to use his/her phone in the classroom for educational purposes? *

There are many ways classroom instruction can be enhanced if students have personal access to the Internet at school.

Yes

Not applicable - no phone

Please provide any additional information you think I should have in the box below.

I look forward to working with you and your student this semester!

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