Electronic Syllabus Signature Form

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Students and Parents, The following form will serve as your electronic signature verifying your understanding of the classroom policies and expectations. Please be sure to scroll through and complete the entire form and then click submit. If you have any concerns, please contact me.

Student's Last Name *

Student's First Name *

Class *

Period 1 - Chemistry GT

Period 2 - Advanced Physical Science

Period 3 - Advanced Physical Science

Period 4A - Advanced Physical Science

Period 4B - Advanced Physical Science

By checking the box below I signify that I understand the classroom expectations and policies. *

I have read and understand the classroom policies.

Required

THE FOLLOWING INFORMATION IS TO BE COMPLETED BY A PARENT/ GUARDIAN *

Full Name Parent/Guardian 1

Parent/Guardian Email 1

Parent/Guardian Preferred Phone Number 1

My preferred method of contact is (Parent/Guardian 1)

Phone

Other:

Full Name Parent/Guardian 2

(optional)

Parent/Guardian Email 2

(optional)

Parent/Guardian Preferred Phone Number 2

(optional)

My preferred method of contact is (Parent/Guardian 2)

(optional)

Phone

Other:

By checking the box below I signify that I have reviewed the classroom policies with my student. *

I have reviewed the classroom policies with my student and understand the policies.

Required

Please provide any additional information about contact/ your child that you would like me to know.

Submit

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