Student Information Form
2019 Hopewell Memorial Jr. High Musical
Production of "Mary Poppins, Jr."
Student Name *
Age *
Grade Level *
Homeroom Teacher *
Last name only. (Please do not use Room Numbers.)
Cast or Crew *
Please indicate whether the student would like to be a member of the Cast or Stage Crew.
PARENT CONTACT INFORMATION
Parent/Guardian Names *
Street Address *
City/State/Zip *
Primary Phone *
Secondary Phone
(optional)
Primary E-mail *
Secondary E-mail
(optional)
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