Authorized and emergency contact form for CMIT North High School
Hello parents,

Please complete the following form as soon as you can, to ensure that we have accurate contact information on file for your student.

If you have any questions, please feel free to contact our school.

Thank you.

Mrs. Bond, Registrar
Mrs. Fermin, School Secretary
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Student Last Name *
Student First Name *
Student ID Number *
Student Current Grade *
Parent #1/Guardian #1 Name *
Parent #1/Guardian #1 phone number *
Parent #1/ Guardian #1 email address *
Parent #2/Guardian #2 Name
Parent #2/Guardian #2 phone number
Parent #2/ Guardian #2 email address
Emergency contact and authorized person #1 to pick up student for early dismissal. (Must show picture ID) *
Emergency contact and authorized person #1 phone number. *
Emergency contact and authorized person #2 to pick up student for early dismissal. (Must show picture ID)
Emergency contact and authorized person #2 phone number.
Emergency contact and authorized person #3 to pick up student for early dismissal. (Must show picture ID)
Emergency contact and authorized person #3 phone number.
Emergency contact and authorized person #4 to pick up student for early dismissal. (Must show picture ID)
Emergency contact and authorized person #4 phone number.
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