Student/Parent Information Form

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Please take a few moments to fill out this information form for Mrs. Pratt, Mrs. Crane and Mrs. Robinson. This will help us stay in contact throughout the year.

Thank you for taking the time to answer these quick questions about you and your child!

Your child's HOMEROOM teacher: *

Please choose from the dropbox below.

Student's Last Name *

Apellido del estudiante

Student's First Name *

Nombre del estudiante

Student's Birthday (month) *

Cumpleaños (mes)

Student's Birthday (day) *

Cumpleaños (dia)

Home Phone *

Numero del teléfono (casa)

What is the best phone number to call during the day? *

¿Cuál es el mejor número de teléfono para llamar durante el día?

Mother's cell phone/ Teléfono celular de la mamá

Father's cell phone/ Teléfono celular de papá

Other

Required

Mother's First & Last Name *

Nombre de mamá

Mother's Cell Phone # *

Número de teléfono celular de mamá

Father's First & Last Name *

Nombre de papá

Father's Cell Phone # *

Número de teléfono celular de papá

Student Lives With... *

Estudiante vive con...

Parent Email Address (el correo electrónico) *

We will use this email to send you updates and info about your child & our class.

Parent Email Address #2 (el correo electrónico)

If you have a second email you'd like me to also use, please enter it here.

If your child has an email address, please enter it below:

(El correo electrónico del niño)

I prefer/ Yo prefiero *

After school my child... *

Despues de la escuela mi hijo/a

Do you allow your child to have a cell phone? *

If yes, do you allow him or her to bring it to school? *

Does your child have any medical conditions, medications or allergies that we need to be aware of? *

Comments/Comentarios

Is there any additional information I should know? Por favor, digame mas informacion importante sobre tu hijo/hija.

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