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Orrs Student Information Sheet
Please fill in every question on this form.
You can fill out one form for your household and include all of your children in one form. If you prefer, you can fill out separate forms for each child. If you have any concerns or questions, please let us know. You can call 770-229-3743 or email
janie.rivera@gscs.org
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* Indicates required question
Email
*
Your email
Student's First and Last Name
*
Your answer
Student's First and Last Name (#2)
Your answer
Student's First and Last Name (#3)
Your answer
Student's First and Last Name (#4)
Your answer
Student's First and Last Name (#5)
Your answer
Grade Level- Check all that apply if you have multiple children at Orrs.
*
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Required
Student's Street Address
*
Your answer
Parent/Guardian's Name
*
Your answer
Parent/Guardian's Cell Phone Number
*
Your answer
Parent/Guardian's Home Phone Number (if this is the same as your cell phone, just type your cell phone again please)
*
Your answer
Relationship to the Student (Mother, Father, etc.)
*
Your answer
Parent/Guardian's Name
Your answer
Parent/Guardian's Cell Phone Number
Your answer
Parent/Guardian's Home Phone Number
Your answer
Relationship to the Student (Mother, Father, Stepmother, etc.)
Your answer
Parent Email Address
*
Your answer
Emergency Contact #1 Name (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
*
Your answer
Emergency Contact #1 Relationship to Student Example: Grandma, Aunt, Friend, etc. (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
*
Your answer
Emergency Contact #1 Phone Number (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
*
Your answer
Emergency Contact #2 Name (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
Your answer
Emergency Contact #2 Relationship to Student Example: Grandma, Aunt, Friend, etc. (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
Your answer
Emergency Contact #2 Phone Number (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
Your answer
Emergency Contact #3 Name (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
Your answer
Emergency Contact #3 Relationship to Student Example: Grandma, Aunt, Friend, etc. (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
Your answer
Emergency Contact #3 Phone Number (This is someone other than parents, whom we may contact if we cannot reach you and to whom you give permission to pick up your child from school.)
Your answer
Please list any medical conditions for your child(ren). If you do not have anything to list, please type N/A.
*
Your answer
If school was back in the building, how would your child(ren) get home?
*
Car Rider
School Bus or Daycare Van Rider
Walker
After School Program at Orrs
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