Student Information Sheet
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Student Information Sheet 2016-2017 Student Name: (First) (Last) Date of Birth: Female Parent 1: (First) (Last) Street Address: City: Home phone : Zip: Cell : Parent Email Address: Parent’s Workplace: Parent’s Profession: Work : Does the student live with you Home phone : City: Zip: Cell : Parent’s Email Address: Parent’s Workplace: Work : Parent’s Profession: Does the student live with you Yes No Are there any other adults that the student resides with If so who Emergency Name Phone : Please note: Parents may not be the Emergency Contact, this number is used in the event that we No (Last) Street Address: cannot reach either parent..
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