Student/Parent Info
Please fill out the questionnaire to help me learn a little more about your child and communicate with you effectively throughout the year. I want to do my best to keep you updated with what we are learning, important days or events and  how your child is progressing.
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Email *
Student Last Name *
Student First Name *
Student Birthdate *
MM
/
DD
/
YYYY
Parent/Guardian Last Name *
Parent/Guardian First Name *
Preferred Contact Phone Number *
Preferred Email *
Second Parent/Guardian Last Name
Second Parent/Guardian First Name
Second Parent/Guardian Contact Number
Second Parent/Guardian Email
Health Concerns *
Required
Describe Health and/or Academic Concerns
If interested in volunteering, what days are you available?
Tell me about your child. Any concerns you want me to be aware of or specific goals for this school year? *
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