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Student/Parent Information
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Student Name *
First and Last
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Student Homeroom *
Student Home Address / Addresses *
Your answer
Parent/Guardian Name(s) & Relation to Student *
Your answer
Parent/Guardian Cell and Home Phone #(s) *
Your answer
Parent/Guardian Occupation(s) *
Please provide workplace phone #(s) if you are available to take calls.
Your answer
Parent/Guardian Email(s)
Your answer
Student Allergies/Health Concerns
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How will your student normally travel to school this year? *
How will your student normally travel home this year? *
Bus Number (if known)
Your answer
Does your student have internet access at home? *
Does your student have a cell phone at school? *
I give my permission for my child to be photographed and for my child's image to be used for classroom/school purposes. I agree that this permission will remain in effect during the 2017-2018 school year. *
**Student images will only be used within Colleton County Middle School. For example: CCMS News Show, Classroom Bulletin Board, Student-of-the-Week Display, etc. Please understand that it is the parent/guardian's responsibility to notify the teacher in the event that you no longer wish to authorize photography and/or use of student image.
Please use this space to tell me anything else you think I should know about your student.
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