Contact Information

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Contact Information

Please complete this form as completely as possible.

Home Address *

Home Phone Number *

Mother's Name

Mother's Contact Phone Number

Mother's E-mail Address

Is it okay to receive an automatic weekly blog update for classroom information through this e-mail address?

Yes

Clear selection

Father's Name

Father's Contact Phone Number

Father's E-mail Address

Is it okay to receive an automatic weekly blog update for classroom information through this e-mail address?

Yes

Clear selection

Who should I contact in case of an emergency? *

Mother

Father

Other:

How should I contact this person? *

Phone

E-mail

Note Home

Emergency Contact Name and Relationship *

Emergency Contact Phone Number *

Would you like to volunteer for our class this year? Please check all that interest you. *

Thursday folders (come every Thursday morning to sort graded papers and weekly flyers)

Classroom Parties (I'll give you the time and ideas if you want. You will need to coordinate with parents about supplies. If you don't want to be "in charge", I can give your name to the person who does so that they know who is willing to help.)

4th Grade Kiss-o-Gram Fundraiser (in February...more information to follow.)

Computer Lab Assistant (Whenever we go to the computer lab, there are lots of questions and only one of me. It's helpful to have another person to answer those questions. You don't have to know anything, you just need to be patient.)

Field Trip Chaperone (We will TRY to go on 2 field trips this year. In case of those, we will need supervising eyes. First come, first serve.)

I am unable to help AT SCHOOL, but let me know if you need anything and I will do my best to send it from home.

I am unable to help, but please keep my up-to-date on my child's progress in 4th grade.

Required

How will your child be getting home from school? *

Bus (Please specify which bus in the box below.)

Car

Walking or Riding Bike

Daycare / Afterschool Care (Please specify the name in the box below.)

Other:

Required

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