Student Information Form
Dr. McGaughy's Kindergarten Class 2017-2018
What is your child's full name?
Your answer
Nickname
Your answer
Date of Birth
MM
/
DD
/
YYYY
Address(Street, City and Zip)
Your answer
Parent/Guardian #1 Full Name
Your answer
Parent/Guardian #1 Address(if same as child's type SAME)
Your answer
Parent/Guardian#1 Cell Phone Number
Your answer
Parent/Guardian #1 Work Number
Your answer
Parent/Guardian #1 Email Address
Your answer
What is Parent/Guardian #1 relationship to the child?
Parent/Guardian #2 Name
Your answer
Parent/Guardian #2 Address
Your answer
What is Parent/Guardian #2 relationship to the child?
Parent/Guardian #2 Cell/Home Number
Your answer
Parent/Guardian #2 Work Number
Your answer
Parent/Guardian #2 Email Address
Your answer
Emergency Contact(Name and Number)
Your answer
Does your child have any allergies?
Your answer
Does your child take any medication
Your answer
Are you willing to be a volunteer?
Additional information I should know about your child
Your answer
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