Class of 2022
I.S. 24 7th grade student information form
Student's Class # *
Student's Last Name *
Student's First Name *
Student Date of Birth *
MM
/
DD
/
YYYY
Parent's Last Name *
Parent's First Name *
Parent E-mail Address *
Home Address *
Home Phone/Alternate Phone *
Parent's Cell Phone *
Emergency Contact Name (First Person) *
Emergency Contact Relationship to Student (First Person) *
Emergency Contact Phone Number (First Person) *
Emergency Contact Name (Second Person)
Emergency Contact Relationship to Student (Second Person)
Emergency Contact Phone Number (Second Person)
Name of any person your child should NOT be released to (if applicable)
If you responded to the above question, is there an order of protection against this person?
Are there any allergies or medications your child has that we need to be aware of? If so, what are they?
Any additional information you would like to share about your child
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