Student Information Form
Please follow formatting examples for phone numbers (include hyphens) and dates MM/DD/YY, and use standard capitalization. Your responses will be printed on forms at school. Thanks!
* Required
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's Preferred Name (name teachers will use)
Your answer
Child's Birthdate MM/DD/YY
*
MM
/
DD
/
YYYY
Who has legal custody?
*
Your answer
Health History of Child
*
Include allergies, medical restrictions, and food restrictions
Your answer
Do you need to add another student?
*
Yes
No
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