Student Information Sheet

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Email *

Student's Full Name *

Student's Date of Birth *

YYYY

Your Name *

Your relationship to the student *

Best phone number to reach a parent during school hours-Please list the parent's name and phone number *

Allergies/ Health concerns *

Email address *

On the first day of school, my child will be a *

For the rest of the first week (Thursday and Friday), my child will be a *

My child's permanent transportation will be ______.(I understand my child will be sent home using this mode of transportation unless a written note is provided to either the teacher or the office.) *

car rider

bus rider

daycare rider

afterschool program

Additional Transportation Info- bus number, car tag number, daycare name, etc.

All students will receive free lunch and breakfast during the 2021-22 school year. Please indicate below if your child will be eating breakfast at school. Your child must be in the classroom no later than 7:30 to allow him/her time to eat and clean up before instruction begins at 7:45. *

Yes, my child will eat breakfast at school.

No, my child will eat breakfast at home.

I will send a note in his/her folder on days that I would like my child to have breakfast.

I want Mrs. Parker and Mrs. Hayli to know this about my child (likes, quirks, special needs, personality traits, favorite characters or activities, etc.). Please list anything that may help us make the first day extra special and begin building a relationship with your child. :)

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