JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
CM Child Information
Thank you so much for updating health, safety and learning information for the 2019-2020 school year. This information will be used in our classroom binders to provide our staff and volunteers with relevant information. Please share any health information that we need to know to keep you child safe and any information relevant to his/her social-emotional or learning needs that will help us care for your child in class.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's Age
*
Your answer
Parent Name(s)
*
Your answer
Parent Cell Phone #s
*
Your answer
Child Information
*
Please list (in numbered list or bullet point form) information about your child. This can include diagnosis, helpful strategies, tips for motivating your child... anything that will help his or her teacher!
Your answer
Emergency Information
Please list (in numbered list or bullet point form) information that we need to have in the event of an emergency.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Glen Ellyn Bible Church.
Does this form look suspicious?
Report
Forms
Help and feedback
Help Forms improve
Report