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Third Grade (Lee) Student Information
Please complete this form prior to our Meet the Teacher on August 19th. Thank you.
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Child's Name (First and Last)
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Your answer
Nickname
Your answer
Birthdate
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MM
/
DD
/
YYYY
Address
*
Your answer
Parent/Guardian Name 1
*
Your answer
Preferred Phone Number
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Your answer
Email
*
Your answer
Parent/Guardian Name 2
Your answer
Preferred Phone Number
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
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Your answer
Phone
*
Your answer
Relationship
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Your answer
Emergency Contact 2
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Your answer
Phone
*
Your answer
Relationship
*
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Siblings (include names,ages, & teacher if South Mebane student)
Your answer
Allergies/Health Concerns
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List any holidays not observed
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What would you like for me to know about your child?
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Form completed by:
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