STUDENT INFORMATION FORM 2008-2009 

As part of the implementation process for the new ALERTNOW notification system, we would like to update our database over the summer so that our student information is as accurate as possible when students arrive in the fall.

Please complete the following information and press the "Submit" button:

                               * Indicates Mandatory Fields

* Student's Name: 

* Student's Mailing Address: 

* DOB:  * Grade in 08-09:  * Gender:     * Place of Birth: 

* Ethnicity:

 

Contact this Parent First:

* Name: 

* Address: 

Work Telephone:     Employer Name:

Cell Number:     * Home Number: 

Email Address:

 

Contact this Parent Second:

Name:

Address:

Work Telephone:     Employer Name:

Cell Number:     Home Number:

Email Address:

 

Emergency Contact #1:

Name:

Address:

Work Telephone:     Employer Name:

Cell Number:     Home Number:

Email Address:

 

Emergency Contact #2:

Name:

Address:

Work Telephone:     Employer Name:

Cell Number:     Home Number:

Email Address:

 

Student Resides with:

Language Spoken at home:

Student's Email Address:

Student's Cell Phone: