East Coast Trip 2012 - Secure Online Contact Form
I already have all your contact and emergency information on the yellow form you turned in at the Pre-Departure Meeting. However, this form will put all my family contact information all in one spreadsheet for me. So, if I need to contact you, it saves time and helps me reach you faster if you fill out this simple, secure online form. Thanks so much for your help. --Mr. Ippolito
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Child's First Name *
Child's Last Name *
CONTACT #1
In an emergency, call this number FIRST: *
Example: (661) 295-3700
Relationship to student *
Example: mother, father, grandmother, legal guardian
Can Mr. Ippolito text this number? *
CONTACT #2
In an emergency, call this number SECOND: *
Example: (661) 295-3700
Relationship to student *
Example: mother, father, grandmother, legal guardian
Can Mr. Ippolito text this number? *
CONTACT #3
In an emergency, call this number THIRD: *
Example: (661) 295-3700
Relationship to student *
Example: mother, father, grandmother, legal guardian
Can Mr. Ippolito text this number? *
Anything else Mr. Ippolito should know?
Before I take your child 3,000 miles away for 6 days, is there anything else important I should know? Any final message you want to give to Mr. Ippolito?
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