Syllabus Approval Form
Campo Verde Band Syllabus Approval
Please read the syllabi on Mr. Kozacek's Teacher Page before submitting this form.
Form Due Date is 8/3/18 and is the first grade entered into the student's gradebook.
Student Last Name *
Your answer
Student First Name *
Your answer
Student Nickname
if applicable
Your answer
Student School ID # *
Your answer
Student Gender *
Student Grade *
Student Mailing Address *
Please include Street, City and Zip
Your answer
Student Cell Phone #
Your answer
Cell Phone Carrier
Verizon, T-Mobile, Sprint, ATT, etc
Your answer
Student Home Phone
Your answer
Student Email Address *
If you don't have one, please create one.
Your answer
Student Date of Birth *
MM
/
DD
/
YYYY
Mother/Guardian's Full Name
Your answer
Mother's Address
If same as students, input "same". Please include Street, City and Zip.
Your answer
Mother's Cell Phone
Your answer
Mother's Cell Phone Carrier
Verizon, T-Mobile, Sprint, ATT, etc
Your answer
Mother's Home Phone
If same as students, input "same".
Your answer
Mother's Email Address
Your answer
Father/Guardian's Full Name
Your answer
Father's Address
If same as students, input "same". Please include Street, City and Zip.
Your answer
Father's Cell Phone
Your answer
Father's Cell Phone Carrier
Verizon, T-Mobile, Sprint, ATT, etc
Your answer
Father's Home Phone
If same as students, input "same".
Your answer
Father's Email Address
Your answer
If there are other guardians or step family members that need to be included, please fill in their information below. Or...they can submit this same form.
Your answer
Syllabus Approval *
Required
Class Fee Approval *
Required
Which class or ensemble are you approving the syllabus for? *
Check all that apply
Required
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