MS54 NEW STUDENT FAMILY FORM
Dear Parents,

MS54 families are requested to fill out the information below so that we can communicate with you during the school year.

If you have any questions, please contact Parent Coordinator Anne Pejovich at amcintosh6@schools.nyc.gov

Thank you for your help.

The Administration, Faculty, Staff & PTA of MS54

STUDENT INFORMATION
Student OSIS number - School ID number *
Your answer
Student's First Name: *
Your answer
Student's Last Name: *
Your answer
Student's Primary Residence Telephone: *
XXX-XXX-XXXX
Your answer
Student’s Address: *
Your answer
PARENT/GUARDIAN #1 INFORMATION
Parent/Guardian #1 First Name: *
Your answer
Parent/Guardian #1 Last Name: *
Your answer
Parent/Guardian #1 Home Phone:
XXX-XXX-XXXX
Your answer
Parent/Guardian #1 Work Phone:
XXX-XXX-XXXX
Your answer
Parent/Guardian #1 Cell Phone:
XXX-XXX-XXXX
Your answer
Parent/Guardian #1 Email:
Your answer
Parent/Guardian #1 Address:
(Leave blank if same as student address)
Your answer
Would you like to volunteer to be a class parent?
PARENT/GUARDIAN #2 INFORMATION
Parent/Guardian #2 First Name:
Your answer
Parent/Guardian #2 Last Name:
Your answer
Parent/Guardian #2 Home Phone:
XXX-XXX-XXXX
Your answer
Parent/Guardian #2 Work Phone:
XXX-XXX-XXXX
Your answer
Parent/Guardian #2 Cell Phone:
XXX-XXX-XXXX
Your answer
Parent/Guardian #2 Email:
Your answer
Parent/Guardian #2 Address:
Your answer
Would you like to volunteer to be a class parent?
Please enter your child's grade *
THANKS FOR YOUR HELP!
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