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Parent Contact Information & Permissions for Ms. Noles' class
Please complete the following contact information for Ms. Noles. Thank you!
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Student Last Name
*
Your answer
Student First Name
*
Your answer
Prefers to be called (if different)
Your answer
Parent/Guardian Last Name
*
Your answer
Parent/Guardian First Name
*
Your answer
Parent/Guardian Email Address
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Emergency Contact Name (other than parent/guardian)
*
Your answer
Emergency Contact Phone Number
*
Your answer
Does your student have any medical issues I should be aware of?
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Yes: ______________________________________
No
Required
Does your student have an IEP, BIP, or 504 plan?
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Yes: _____________________________________
No
Required
What block/class does your student have Noles?
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2nd Block AP European History
3rd Block American History I
4th Block Honors American History I
Movie Permission- sometimes we may view videos and clips that are rated R due to violence or language. I edit these carefully and show at my discretion to help give students visual representation of an era or event.
*
Yes my child may watch movies and video clips that may be PG-13 or R at Ms. Noles' discretion
No my child may not watch movies and video clips at Ms. Noles' discretion
Other:
Permission to publish work and/or images created by or of your student on educational websites (such as our class site) or class blogs
*
Yes
No
Other:
What would you like me to know about your student?
Your answer
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