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Student Contact Information
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Homeroom Section
*
Choose
8.1
8.2
8.3
8.4
8.5
8.6
Guardian Name
*
Your answer
Relationship to Student
*
Check all that Apply
Mother
Father
Legal Guardian
Aunt/Uncle
Grandparent
Sibling
Other:
Required
Mailing Address
*
Your answer
Cell Phone Number
Your answer
Do you prefer text messages?
Yes
No
Other:
Clear selection
Other Phone Number (Optional)
Please tell whose number this is if not your own
Your answer
Other Phone Number (Optional)
Please tell whose number this is if not your own
Your answer
Email
Your answer
Does your child do any of the following?
Check all that apply
Ride the Bus
Pick a Sibling up from Jefferson/Gregory
Allowed to stay after school if you are notified
Plan on playing a sport
Unable to stay after school for any reason
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