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Rode- Student Information Sheet
Please fill out the following information about your student. I will need this information for my records.
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* Indicates required question
Student Name (First and Last)
*
Your answer
Mother's Name (First and Last)
Your answer
Mother's Cell Phone Number
Your answer
Father's Name (First and Last)
Your answer
Father's Cell Phone Number
Your answer
Please enter an email address that can be used to contact you (You may enter more than one, if needed)
*
Your answer
How will your child get home ON THE FIRST DAY OF SCHOOL? If bus, please indicate the number or program. If car pickup, this will be in the front.
*
Your answer
How will your child get home each day NORMALLY? If bus, please indicate the number or program. If car pickup, this will be in the front.
*
Your answer
Do you have Internet access at home?
*
Yes
No
Yes, but it does not work well (Limited service)
No, but I plan on getting Internet service
What type of technology devices do you have at home that can be used for learning, if necessary? Check all that apply.
*
Computer
Laptop
iPad or Tablet
Smartphone
I DO NOT have a computer or technology device.
Other:
Required
Is there anything that I might need to know about your child or be aware of?
Your answer
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