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Student Record Database
Now that your child is successfully enrolled at CLASS Academy, please take a moment to complete the important contact information form.
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* Indicates required question
Email
*
Your email
Student First Name
*
Your answer
Student Last Name
*
Your answer
Primary Guardian Name (First & Last)
*
Your answer
Primary Guardian Phone Number
*
Your answer
Primary Guardian Email
*
Your answer
Additional Guardian Name (First & Last)
Your answer
Additional Guardian Phone Number
Your answer
Student Home School District
*
Your answer
Student's Current Address (#, Street - Ex. 270 Ohio River Blvd.)
*
Your answer
Student's Current City (City Name, State - Ex. Ambridge, PA)
*
Your answer
Student's Current Zip Code (Zip Code - Ex. 15005)
*
Your answer
Emergency Contact - Other Than Above (FULL NAME)
*
Your answer
Emergency Contact - Phone Number
Your answer
Student Allergies - Please list any student allergies below:
Your answer
Student Medication - Please list any student medications taken:
Your answer
Is student allowed to take Tylenol/Ibuprofen during school day?
*
Yes
No
Other:
Please list the phone numbers you would like included in the school Digital Notification System - Phone #1
*
Your answer
Please list the phone numbers you would like included in the school Digital Notification System - Phone #2
Your answer
Please list the phone numbers you would like included in the school Digital Notification System - Phone #3
Your answer
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