Huskerson/Wood Student Information Form/Survey
Homeroom Teacher
Student's Full Name
Your answer
Student's Preferred Name
Your answer
Student's D.O.B.
MM
/
DD
/
YYYY
Address
Your answer
Home Phone #
Your answer
Parent 1's Name
Your answer
Parent 1's Cell Phone #
Your answer
Parent 2's Name
Your answer
Parent 2's Cell Phone #
Your answer
Emergency Contact
Your answer
Emergency Contact's #
Your answer
Applicable Medical Information
Your answer
Email Address(es):
Your answer
B.ring Y.our O.wn T.echnology
(If bringing a learning device daily once we launch B.Y.O.T.)--check all options that apply)
1st Day of School Transportation
NORMAL MODE OF TRANSPORTATION
Parent 3-2-1 Survey
3 Words that best describe your child:
Your answer
2 Things I should know about your child: (Recent Changes, Medications, Concerns, Strengths, Weaknesses, etc.)
Your answer
1 Wish that you have for your child this year:
Your answer
NOTES: Share here any thoughts, questions, comments, or concerns. Thanks!
Your answer
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