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Student Information
Please complete this form by Tuesday, Aug. 24. Thank you.
~Stephanie Allmond
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* Indicates required question
Child's Name (First and Last)
*
Your answer
Nickname
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Address
*
Your answer
Preferred Phone Number
*
Your answer
Parent/Guardian Name 1
*
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Email
*
Your answer
Parent/Guardian Name 2
Your answer
Address (if different from above)
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
Email
Your answer
Emergency Contacts
Include the names and phone numbers of two contacts other than parents. These people will be contacted if the parents/guardians cannot be reached.
Emergency Contact 1
*
Your answer
Phone
*
Your answer
Relationship
*
Your answer
Emergency Contact 2
*
Your answer
Phone
*
Your answer
Relationship
*
Your answer
Siblings (include names,ages, & teacher if South Mebane student)
Your answer
Allergies/Health Concerns
Your answer
List any holidays not observed
Your answer
What would you like for me to know about your child?
*
Your answer
Please list some of your child's successes from kindergarten.
*
Your answer
Please list some of your child's challenges from kindergarten.
*
Your answer
Best time to contact you (examples: mornings, after 5:00, before 8pm)
*
Your answer
Preferred method(s) of parent/teacher communication
*
Dojo message
Email
Text
Phone call
Required
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