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Contact Information
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Email
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Your email
Student's Name (Last, First)
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Your answer
Please select your child's homeroom number.
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203 - Ms. Stupp
204 - Mrs. Dietrich
206 - Mrs. Kurtzman
Names of Parents/Guardians
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Your answer
Email #1
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Your answer
Email #2
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Your answer
Best Number to Reach You (You may list more than one.)
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Your answer
Please check one...
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I give permission for my child's photo, work, and name to be posted on the class website AND in school.
I give permission for my child's photo, work, and name to be posted ONLY in the classroom.
I DO NOT give permission for my child's photo, work, and name to be posted either online or in the classroom.
Other (Please see next question)
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If you selected "other" in the question above, please clarify your selection in the space below.
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Any information about your child you feel the teachers should know.
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