2017-18 Student Information Forms
This google form is replacing the five (5) forms that MICS is required to have for each student. Parents MUST submit a response for each child.
Student's Legal Last Name
Your answer
Student's Legal First Name
Your answer
Student's Middle Name
Your answer
Birthdate
MM
/
DD
/
YYYY
Grade in 2017-18
Primary Contact Number (ie: xxx-xxx-xxxx)
Your answer
Home Address
Your answer
City
Your answer
Zip
Your answer
County Where Student Resides In
Mailing Address (if different)
Your answer
Parent's Email Address #1
Your answer
Parent's Email Address #2
Your answer
Student Resides With: (State-mandated categories)
Father's Name (First and Last)
Your answer
Address (if different)
Your answer
Primary Contact Number (ie: xxx-xxx-xxxx)
Your answer
Work Phone (ie: xxx-xxx-xxxx)
Your answer
Home Phone (if different)
Your answer
Mother's Name (First and Last)
Your answer
Address (if different)
Your answer
Primary Contact Number (ie: xxx-xxx-xxxx)
Your answer
Work Phone (ie: xxx-xxx-xxxx)
Your answer
Home Phone (if different)
Your answer
Stepmother's/Stepfather's Name (if living with student)
Your answer
Cell Phone (ie: xxx-xxx-xxxx)
Your answer
Home Phone (if different)
Your answer
Is either parent a military employee or work on government property? If so, what is your place of employment?
Your answer
Media/Photographic Release Authorization
I give my permission for my child to be photographed or recorded, either visually or orally, by school personnel, media personnel, or others authorized by the school for the purpose of education, public relations, or any other purposes deemed necessary by MICS. This includes his/her name and image on the MICS website and in the MICS yearbook. This authorization automatically renews each year until revoked or the student withdraws from the school.
Required
Directory Listing Authorization
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