Student Information 2022-2023
Please fill out the following information about your child.
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Student Name (Last, First) *
Home Address *
Mother/Guardian's Name (Last, First) *
Mother/Guardian's Phone Number
Father/Guardian's Name (Last, First) *
Father/Guardian's Phone Number
Email(s) for Weekly Updates and Communication *
Emergency Contact Name *
Emergency Contact's Phone Number *
Transportation on the FIRST DAY of school (if bus please put slot/bus number) *
Daily Transportation for the SCHOOL YEAR (if bus please put slot/bus number) *
Would you like to volunteer in the classroom?  *
Allergies and/or Health Concerns *
Is there anything special I need to know about your child? *
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