Student Contact Information
To best serve the youth at Legacy, we would like to keep up-to-date contact information and basic health information on file for all of our students. Please take a few moments to answer each of the following questions. We appreciate your help in this! (You can update this information at any time.)
First Name *
Your answer
Last Name *
Your answer
Please select *
Birthdate *
Your answer
*
Your answer
Home Phone *
Your answer
Student Cell Phone (if applicable)
Your answer
Student Email (if applicable)
Your answer
School *
Your answer
School City *
Your answer
Comments
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Jefferson County Public Schools. Report Abuse - Terms of Service