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Abraham Lincoln Elementary Digital Emergency Contact Information Form
Please fill out this form as completely as possible so we can update our records.
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* Indicates required question
Email
*
Your email
Student Last Name
*
Your answer
Student First Name
*
Your answer
Student Middle Name
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Street Address, Including Apt# if applicable.
*
Your answer
Zip Code
*
Your answer
Parent/Guardian #1 Last Name
*
Your answer
Parent/Guardian #1 First Name
*
Your answer
Does this parent live in the household with child?
*
Yes
No
Parent/Guardian #1 Street Address
*
Your answer
Parent/Guardian #1 City
*
Rancho Cordova
Sacramento
Other:
Parent/Guardian #1 Zip Code
*
Your answer
Parent/Guardian #1 Primary Phone Number
*
Your answer
Parent/Guardian #1 Cell Phone Number
*
Your answer
Parent/Guardian #1 Work Phone
Your answer
Parent/Guardian #1 Email Address
Your answer
Parent/Guardian #2 Last Name
Your answer
Parent/Guardian #2 First Name
Your answer
Does this parent live in the household with child?
*
Yes
No
Parent/Guardian #2 Street Address
Your answer
Parent/Guardian #2 City
*
Rancho Cordova
Sacramento
Other:
Parent/Guardian #2 Zip Code
Your answer
Parent/Guardian #2 Primary Phone Number
Your answer
Parent/Guardian #2 Cell Phone
Your answer
Parent/Guardian #2 Work Phone
Your answer
Parent/Guardian #2 Email Address
Your answer
List names of other children attending this school:
Your answer
If parents are divorced or separated, to whom has physical custody been given? (please email updated verification to
tracyhi@scusd.edu
)
Your answer
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