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Contact Information
Please include all contact information below so that I will be able to contact you / your parents throughout the school year. Thank you, Mrs. Chapman
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Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Student's Class Period
*
Your answer
Mom's First & Last Name
Your answer
Mom's E-Mail Address
Your answer
Mom's Phone Number
Your answer
Mom's Phone Number
Cell Phone
Home Phone
Work Phone
Clear selection
Dad's First & Last Name
Your answer
Dad's E-Mail Address
Your answer
Dad's Phone Number
Your answer
Dad's Phone Number
Cell Phone
Home Phone
Work Phone
Clear selection
Primary Language Spoken At Home
*
Choose
English
Spanish
Other
If Other, what is the primary language?
Your answer
Do you have internet access at home?
*
Yes
No
Please list any other information you would like me to have.
ex. Best to contact at night, Best to contact in the morning, etc.
Your answer
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