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Kindergarten & New Student to the District ONLY- Elementary Update Form 2021-2022
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* Indicates required question
Student Last Name
*
Your answer
Student First Name
*
Your answer
Student ID#
Your answer
Grade
*
Choose
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Homeroom Teacher
*
Choose
Mrs. Allar
Mrs. Boone
Miss A. Brand
Miss Brixius
Ms. Cleary
Miss Cochran
Mrs. Debus
Mr. Gray
Mrs. Halcovich
Mrs. Hatfield
Mr. Hewes
Mrs. Holland
Mrs. Kramer
Mrs. Medeiros
Mrs. Moyer
Mrs. Pontician
Mrs. Reimer
Mrs. Reiter
Mr. Rizzardi
Mrs. Robinson
Miss Schneck
Mrs. Schwartz
Ms. Seavey
Miss Seiger
Mrs. Shollenberger
Mrs. Skripko
Mrs. Ulsh
Mrs. VanTries
Mrs. White
Mrs. Withrow
Student's Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Siblings attending PGASD *(please separate by comma)
Your answer
Student Primarily Resides With:
*
Both Parents
Father
Father/Step-Mother
Mother
Mother/Step-Father
Guardian
Other:
Father's Name
Your answer
Address
Your answer
Home Phone Number
Your answer
Cell Phone Number
Your answer
Work Phone Number
Your answer
Employer
Your answer
E-Mail *(if none, type none)
*
Your answer
Mother's Name
Your answer
Address
Your answer
Home Phone Number
Your answer
Cell Phone Number
Your answer
Work Phone Number
Your answer
Employer
Your answer
E-Mail *(if none, type none)
*
Your answer
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