Student contact info form 2024-25
Please fill out these questions as best you can
Student last name *
Student first name (as shown on school records) *
If you have a name you prefer to be called that is different than the one above, please let me know
Which personal pronoun do you prefer people use when referring to you? *
If you answered "other" to the last question, which pronoun do you use to describe yourself?
Which class and period do you have Mr. Klakovich? *
If you have any physical limitations that will prevent you from going on walking field trips, please explain these below.
If you have any concerns please talk to me. If there is something that is important for me to know about you that you would rather not discuss with me in person, please let me know here.
FOR THE STUDENT: By checking the box below, you, the student, are indicating that you have read and understand all of the information written in the Class Syllabus and Safety Contract and are agreeing to live up to these expectations and face the consequences when you do not. *
Gerekli
FOR THE PARENT: By checking the box below, you, the parent or legal guardian, are indicating that you have read and understand all of the information written in the Class Syllabus and Safety Contract. *
Gerekli
Name of parent or guardian *
parent email (write NONE if you don't use one) *
parent phone (best number to reach you) *
If it is difficult for you to communicate in English, please let me know which language you are more comfortable with (Si le resulta difícil comunicarse en inglés, hágame saber con qué idioma se siente más cómodo)
إذا كان من الصعب عليك التواصل باللغة الإنجليزية ، فيرجى إبلاغي باللغة التي تفضلها أكثر
Second parent name (optional)
Second parent email (optional)
Second parent phone (optional)
If your child has any severe allergies that may result in anaphylactic shock, please list the trigger(s) here
(bees, foods,...)
If you answered yes to the above question, does your child carry an EpiPen or Auvi-Q?
Seçimi temizle
FOR THE PARENT: Please let me know if you have any special concerns about your child that you would like me to know about. Information included will be kept strictly confidential.
Gönder
Formu temizle
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Bu form Chapel Hill-Carrboro City Schools alanında oluşturuldu. Kötüye Kullanımı Bildirme
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