WECHS Student Information Form
This information will be kept confidential and used only by the WECHS staff and liaison.
First name *
Your answer
Last name *
Your answer
Name you preferred to be called *
Your answer
Grade *
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Street address *
(where you live most of the time)
Your answer
City *
(where you live most of the time)
Your answer
State *
(where you live most of the time)
Zip code *
(where you live most of the time)
Your answer
Home phone number (with area code)
(where you live most of the time)
Your answer
Do you have internet access at this location? *
(where you live most of the time)
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Street address
(secondary residence, if needed)
Your answer
City
(secondary residence, if needed)
Your answer
State
(secondary residence, if needed)
Zip code
(secondary residence, if needed)
Your answer
Home phone number (with area code)
(secondary residence, if needed)
Your answer
Do you have internet access at this location?
(secondary residence, if needed)
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Email address that you check regularly *
Your answer
Cell phone number (with area code) *
Enter n/a if you don't have a cell phone.
Your answer
Do you send and receive text messages?
Leave blank if you don't have a cell phone.
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What language(s) is spoken at home? *
Your answer
If your parents/guardians speak a language other than English at home, how good is their English?
Enter n/a if English is the only language spoken at home.
Your answer
Parent/Guardian name(s) *
Your answer
Parent/Guardian phone number(s) *
Enter n/a if they don't have a phone.
Your answer
Parent/Guardian email(s) *
Enter n/a if they don't have an email address.
Your answer
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Den leader *
Home district *
On community stop days, do you ride the bus? *
If you DO ride a bus on community stop days, where are you picked up/dropped off? *
Enter n/a if you don't ride the bus on community stop days.
Your answer
If you DON'T ride a bus on community stop days, would you, if the stop location was more convenient for you? *
What is your t-shirt size? (Men's sizes) *
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