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Orientation Documentation
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* Indicates required question
Email
*
Your email
Student Grade for the 2021-2022 School Year:
*
K
1
2
3
4
5
Students' Teacher for the 2021-2022 School Year
*
Houston
Pearson
Gray
Johnson
Smith
Brown
Caldwell
Hendrix
Story
Adams
Barnhill
Black
Greer
Bollinger
Lechtner
Hartsell
Barr
Lewis
Rickman
Rochester
Austin
Student Name:
*
Your answer
Guardian Name:
*
Your answer
Guardian Phone Number:
*
Your answer
Student ID# (same as lunch number)
Your answer
Students Date of Birth:
*
MM
/
DD
/
YYYY
Is there a custody agreement on file?
*
Yes
No
No custody issues
Other:
Please list the name, relationship, and phone number of those whom you give permission to pick up your student.
*
Your answer
Students Doctor
*
Your answer
Students Dentist
*
Your answer
List the students medical conditions:
Your answer
List medications your child takes NOW
*
Your answer
List medications your child will need to take at school
*
Your answer
Do you give permission/authorization for the school nurse to contact your child's healthcare provider about health conditions checked above?
*
Yes
No
Maybe
Other:
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