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Parent survey
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* Indicates required question
Student's first name
*
Your answer
Student's last name
*
Your answer
Nickname
Your answer
Birthday
*
MM
/
DD
/
YYYY
Parent 1 name (first and last)
*
Your answer
Parent 1 cell phone number
*
Your answer
Parent 1 email address
*
Your answer
Parent 2 name (first and last)
Your answer
Parent 2 cell phone number
Your answer
Parent 2 email address
Your answer
Who will pick your child up from school? Include name and phone number if different than above
*
Your answer
List any other emergency contacts you would like to have on file
Your answer
List any food allergies or medical conditions
Your answer
Tell me something special about your child
Your answer
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