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2022-2023 Parent Information
Please complete this form with the requested information so that we can stay in contact this school year. If you have any specific concerns during the year, feel free to email us.
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* Indicates required question
Email
*
Your email
Student Legal Last Name
*
Your answer
Student Legal First Name
*
Your answer
Name Student Prefers
Your answer
Student Date of Birth
*
MM
/
DD
/
YYYY
Student's Legal Guardian(s)
*
Your answer
Preferred Email Address (please enter one email)
*
Your answer
Additional Email Address (please enter one email)
Your answer
Guardians Telephone Number (please include area code)
*
Your answer
Student lives with
*
Choose
Both Parents
Mom
Dad
Other
Homebase Teacher
*
Choose
Mrs. Bakke
Mr. Jackson
Mrs. Kundla
A copy of your responses will be emailed to the address you provided.
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