Student Information Survey
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Student Information
Child's Name *
First and Last Name
Is there another name your child would like on their name tag?
Nickname
Address with Zip Code *
Home Phone # *
(123) 456-7890
Student's Birthday *
**/**/****
MM
/
DD
/
YYYY
Does your child have any allergies or medical conditions that I need to know about? *
Parent Information
Mom's Name *
First and Last Name
Mom's Cell # *
(123) 456-7890
Mom's Email *
Dad's Name *
First and Last Name
Dad's Cell # *
(123) 456-7890
Dad's Email *
What is the best way to communicate with you? *
Please check all that apply.
Required
If you are able to volunteer your time helping me, please select how you can assist me below?
Please check all that apply.
Transportation for the School Year
How will your child be going home the FIRST day of the school year? *
How will your child be going home the rest of the school year? *
If there is something I need to know about your child's way home, please let me know here.
Ex. Bus rider on Mondays and car rider the rest of the week
Technology Permission
Please take the time to go onto Parent Portal and update these questions to YES. We are using the internet daily and if your child does not have permission to use the internet, they will not be able to participate in many lessons. Also, I have a Weebly that I like to post blogs and information about our class. If I don't have permission to use your child's picture, they will not be included on the Weebly.
Does your child have NEISD approved photograph or likeness permission? *
Do I have permission to photograph your child and post to our website? This was done at registration and can be updated anytime during the year through parent portal.
Does your child have NEISD approved internet use permission? *
Can your child access the internet while at school via computer lab, library, devices in class? This was done at registration and can be updated anytime during the year through parent portal.
Additional Information
Please list any concerns or anything about your child that you feel I need to know, please let me know here.
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