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P.S/I.S 187 Online Blue Card 2020
We will be collecting the Blue Card information virtually this year so we can access it if we need to go remote. Please fill in the email address of the person filling out this form in case we have a question.
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* Indicates required question
Email
*
Your email
Student's Last Name (Apellido del estudiante):
*
Your answer
Student's First Name (Nombre del estudiante):
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Your answer
Date of Birth (Fecha de nacimiento : mes/dia/año)
*
MM
/
DD
/
YYYY
Gender (Genero)
*
Female
Male
Prefer not to say
Other:
Student's OSIS (Numero de identification )
*
Your answer
Parent/Guardian #1: Last Name (Apellido del padre o tutor con el que vive el estudiante)
*
Your answer
Parent/Guardian #1: First Name (Nombre del padre o tutor)
*
Your answer
Parent/Guardian #1: Relationship (Relacion)
*
Your answer
Parent/Guardian #1: Preferred Written Language (Idioma de preferencia del padre para comunicarse escrito)
*
Spanish
English
Chinese
Ukrainian
Arabic
Mandarin
Russian
Other:
Parent/Guardian #1: Preferred Oral Language (Idioma de preferncia del padre para comunicarse oral)
*
Spanish
English
Chinese
Ukrainian
Arabic
Mandarin
Russian
Parent/Guardian #1: Home Number (Telefono de la casa)
*
Your answer
Parent/Guardian #1: Cell Number (Celular)
*
Your answer
Parent/Guardian #1: Email (Correo electronico)
*
Your answer
Parent/Guardian #1: Address (Direccion,numero de casa y calle, numero de apartamento)
*
Your answer
Parent/Guardian #2: First Name (Nombre del padre o tutor)
Your answer
Parent/Guardian#2: Last Name (Apellido del parde o tutor con el que vive el estudiante)
Your answer
Parent/Guardian #2: Relationship (Relacion)
Your answer
Parent/Guardian #2: Preferred Written Language (Idioma de preferencia del padre para comunicarse escrito)
Spanish
English
Chinese
Ukrainian
Arabic
Mandarin
Russian
Clear selection
Parent/Guardian #2: Preferred Oral Language (Idioma de preferncia del padre para comunicarse oral)
Spanish
English
Chinese
Ukrainian
Arabic
Mandarin
Russia
Clear selection
Parent/Guardian #2: Home Number (Telefono de la casa)
Your answer
Parent/Guardian #2: Cell Number (Celular)
Your answer
Parent/Guardian #2: Email (Correo electronic)
Your answer
Parent/Guardian #2: Address (Direccion numero de casa y calle, numero de apartamento)
Your answer
List below names of three (3) persons who may be called in case of emergency or if child is sick: (Please include name, telephone and relationship to child) Enumere abajo tres (3) personas a las que se puede llamar en caso de emergencia o si el estudiante se enferma en la escuela. SOLO PODRAN RECOGER AL ESTUDIANTE LAS PERSONAS CUYO NOMBRES APARECEN EN ESTA TARJETA.
*
Your answer
If there is a person who may NOT HAVE ACCESS to child, please indicate: name, relationship and if an order of protection is in place. (Indique aqui si hay alguna persona que NO DEBE TENER ACCESO al estudiante)
*
Your answer
Child's Grade, Class, Teacher (Grado del estudiante)
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Your answer
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