Charms Student Information Form
Student's Last Name *
Student's Middle Name
Student's First Name *
Address *
Address (Apt, Building etc.)
City *
State *
Zip *
Home Phone
Cell Phone
Student's Email
Student's Band Groups (check all that apply) *
Required
Grade *
Sex
Height (example 5' 8")
T-shirt Size (example Medium-Adult) *
Birthday
MM
/
DD
/
YYYY
Instrument 1 *
Instrument 2
Instrument 3
Private Teacher
Locker #
Locker Combination
Parent/Guardian/Other Contact - Relation *
Parent/Guardian/Other Contact - Prefix (Mr. Ms. etc.)
Parent/Guardian/Other Contact - First Name *
Parent/Guardian/Other Contact - Last Name *
Parent/Guardian/Other Contact - Address *
Parent/Guardian/Other Contact - Address (cont.)
Parent/Guardian/Other Contact - City *
Parent/Guardian/Other Contact - State *
Parent/Guardian/Other Contact - Zip *
Parent/Guardian/Other Contact - Home Phone *
Parent/Guardian/Other Contact - Work Phone
Parent/Guardian/Other Contact - Cell Phone *
Parent/Guardian/Other Contact - Email Address *
Second Parent/Guardian/Other Contact - Relation
Second Parent/Guardian/Other Contact - Prefix (Mr. Ms. etc.)
Second Parent/Guardian/Other Contact - First Name
Second Parent/Guardian/Other Contact - Last Name
Second Parent/Guardian/Other Contact - Address
Second Parent/Guardian/Other Contact - Address (cont.)
Second Parent/Guardian/Other Contact - City
Second Parent/Guardian/Other Contact - State
Second Parent/Guardian/Other Contact - Zip
Second Parent/Guardian/Other Contact - Home Phone
Second Parent/Guardian/Other Contact - Work Phone
Second Parent/Guardian/Other Contact - Cell Phone
Second Parent/Guardian/Other Contact - Email Address
Third Parent/Guardian/Other Contact - Relation
Third Parent/Guardian/Other Contact - Prefix (Mr. Ms. etc.)
Third Parent/Guardian/Other Contact - First Name
Third Parent/Guardian/Other Contact - Last Name
Third Parent/Guardian/Other Contact - Address
Third Parent/Guardian/Other Contact - Address (cont.)
Third Parent/Guardian/Other Contact - City
Third Parent/Guardian/Other Contact - State
Third Parent/Guardian/Other Contact - Zip
Third Parent/Guardian/Other Contact - Home Phone
Third Parent/Guardian/Other Contact - Work Phone
Third Parent/Guardian/Other Contact - Cell Phone
Third Parent/Guardian/Other Contact - Emal Address
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