Student Information
Please fill out the student and parent information form completely. Thank You!
Student's Name (First and Last) *
Name Child Goes By *
Date of Birth *
MM
/
DD
/
YYYY
Lives With *
Phone Number (best to reach you at) *
Preferred email *
Do you prefer a digital or physical copy of newsletters and other classroom info sheets? *
Mother/Guardian's Name (first & last)
Mother/Guardian's phone number
Father/Guardian's Name (first & last)
Father/Guardian's phone number
Siblings (name, grade, teacher)
Emergency Contact (name, relationship to child, best number to reach them) *
Student Heath Issues (allergies, medical issues, glasses, etc.)
Behavior Concerns
How will your child get home on the FIRST day? *
How will your child get home the rest of the year? *
I give permission for [check all that apply]: *
Required
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