Student Information
Please complete this form prior to Meet the Teacher on Thursday, August 22nd.  Thank you.
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General Information
Child's Name *
Nickname
Address *
Preferred Phone Number *
Parent/Guardian Name 1 *
Home Phone
Cell Phone
Work Phone
Email
Parent/Guardian Name 2
Address (if different from above)
Home Phone
Cell Phone
Work Phone
Email
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 *
Phone *
Relationship *
Emergency Contact 2 *
Phone *
Relationship *
Other information
Siblings (include names,ages, & teacher if South Mebane student)
Allergies/Health Concerns
List any holidays not observed
What would you like for me to know about your child? *
Transportation
Please complete transportation information (walker, car, Third Street After School Care, Bus number, etc.).  If transportation ever changes, please send a note or call the office.  Thanks.
Arrival to School *
Departure on FIRST DAY *
Departure after first day *
Form completed by: *
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