Student Contact Information Form

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Please fill out this form with current information on your child.

When it comes to contacting you throughout the year, I will use e-mail for the most part. This will be the primary form of communication between us making it easy and quick to stay in contact. I will also keep my website updated so that you will always be "in-the-know." However, if there is a need, I will not hesitate to call or send a note to you.

Note--If the information below is the same in multiple fields, please just type "same." If the field is required and that information is unavailable, please just type "N/A."

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Please Fill Out The Secure Student Information Form Below

Student's Full Name *

Student's Home Phone *

Student's Home Address *

Mother's Name (First and Last) *

Mother's E-mail Address *

Mother's Home Phone Number *

Mother's Cell Phone Number *

Mother's Work Phone Number *

Father's Name (First and Last) *

Father's E-mail Address *

Father's Home Phone Number *

Father's Cell Phone Number *

Father's Work Phone Number *

Please indicate the best phone number to reach you during any time of the day (in case of an emergency/urgent phone call). PLEASE JUST CHECK ONE BOX FOR THIS QUESTION... *

Mother's Home Phone

Mother's Cell Phone

Mother's Work Phone

Father's Home Phone

Father's Cell Phone

Father's Work Phone

Обавезно

Any other emergency contact names (please include the relationship to student and phone numbers): *

Please include any additional information that would be helpful for me to know as your child's teacher. (Example: child lives with Mom Sunday-Wednesday and Dad Thursday-Saturday, Mom or Dad are away for part of the school year due to work/military, student allergies, etc.) **If no additional information is necessary then please put N/A. *

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