Student Information
Please fill in or circle all blanks to your best knowledge
Last Name:_______________________________ Grade:_________
First Name:_______________________________ ID#:____________ Birthdate:_________________________________
Lives with: Parents/Mom/Dad/Other:__________________________________________
Guardians Name(s):_______________________________________________________
Address:________________________________________________________
City:_______________________ Zip Code:___________________
Home Phone:_____________________WorkPhone:____________________
Cell Phone:_______________________ Do you accept texts:_____________
Parent E-mail:__________________________________________________
Student E-mail:__________________________________________________
Which of these is your preferred method of communication?_________________________________________________
Medical Concerns that we should be aware of:_____________________________________________________________
Any other information that we should be made aware of:__________________________________________________________________________________________________________________________________________________________________________