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Student and Parent Inventory
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* Indicates required question
1. Student Name
*
Your answer
2. Student Address
*
Your answer
3. Student Birthdate
*
MM
/
DD
/
YYYY
4. Student lunch number
*
Your answer
5. Student lives with...
*
Mother and Father
Mother only
Father only
Mother and Stepfather
Father and Stepmother
Grandparents
Guardian
6. Mother's name
*
Your answer
7. Mother's cell #
*
Your answer
8. Mother's home #
*
Your answer
9. Mother's work #
*
Your answer
10. Mother's email address
*
Your answer
11. Father's name
*
Your answer
12. Father's cell #
*
Your answer
13. Father's home #
*
Your answer
14. Father's work #
*
Your answer
15. Father's email address
*
Your answer
16. Guardian's name (other than mother or father)
Your answer
17. Guardian's cell #
Your answer
18. Guardian's home #
Your answer
19. Guardian's work #
Your answer
20. Guardian's email address
Your answer
21. Emergency contact name and phone #
*
Your answer
22. Is there anything about your child you would like for us to know?
*
Your answer
23. List any allergies your child has.
*
Your answer
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