Catalina Student Info Form (2018-2019)
Please fill in the following information so that we have your most up-to-date info for the airline and CIMI. Please inform your parents that you are giving out their contact information so they are not surprised to hear from us.
Thanks!
-Mr. Hammack & Ms. DeLaPaz
LAST name *
As it appears on your ID
Your answer
FIRST name *
As it appears on your ID
Your answer
Birth Month *
Birth Date *
Birth Year *
Gender Identity *
Grade (2018-2019 school year) *
Which class are you taking this year? *
Which period are you enrolled in APES/AP Bio? *
Do you have any special dietary needs? Please include serious food allergies here. *
Please make sure to remind your teacher about this on the trip.
Your Email *
Your answer
Mom's Email *
Your answer
Dad's Email *
Your answer
Your cell phone number *
Enter as xxx-xxx-xxxx
Your answer
Your parents' home phone number (in case of emergency) *
Enter as xxx-xxx-xxxx
Your answer
Mom's Name *
Your answer
Your mom's cell phone number (in case of emergency) *
Enter as xxx-xxx-xxxx
Your answer
Dad's Name *
Your answer
Your dad's cell phone number (in case of emergency) *
Enter as xxx-xxx-xxxx
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms