2020-2021 CCHS Student Information Sheet
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Email *
Grade *
Student Name *
Date of Birth *
MM
/
DD
/
YYYY
Race *
Sex *
County of Residence *
Mailing Address: *
Physical Address *
City *
State *
Zip Code *
Home Phone Number *
A parent or legal guardian's email address
Mother's Name *
Mother's Employer *
Mother's phone number *
Mother's phone number *
Mother's Work Number
Father's Name *
Father's Employer
Father's Phone Number *
Father's Work Number
In case of an EMERGENCY and the Parent or Guardian cannot be reached, whom do we call? Please provide 2 other numbers and names besides your own. We must have NAME, RELATION, and PHONE NUMBER of at least two Emergency contacts.
First Emergency Contact Name *
First Emergency Contact Relation *
First Emergency Contact Phone Number *
Second Emergency Contact Name *
Second Emergency Contact Relation *
Second Emergency Contact Number *
Please NOTIFY the school any time you have a change of address or Phone Number.
The Calhoun County School System prohibits discrimination on the basis of race, color, national origin, gender of disability in our educational programs or activities.
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