Is a language other than English used in the home? *
If Yes, what is that language
Your answer
If Yes, is that other language spoken in the home
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Student resides with *
Are there Legal/Custody Papers pertaining to this child? Please note, the school must have a copy of the court order on file declaring custody arrangement. *
Guardian 1 First Name
Your answer
Guardian 1 Last Name
Your answer
Guardian 1 Home Phone Number
Your answer
Guardian 1 Cell Phone Number
Your answer
Guardian 1 Mailing Address
Your answer
Guardian 1 City, State, Zip Code
Your answer
Guardian 1 E-Mail Address
Your answer
Guardian 1 Place Of Employment
Your answer
Guardian 1 Work Phone Number
Your answer
Guardian 2 First Name
Your answer
Guardian 2 Last Name
Your answer
Guardian 2 Home Phone Number
Your answer
Guardian 2 Cell Phone Number
Your answer
Guardian 2 Mailing Address
Your answer
Guardian 2 City, State, Zip
Your answer
Guardian 2 E-Mail Address
Your answer
Guardian 2 Place Of Employment
Your answer
Guardian 2 Work Phone Number
Your answer
Emergency Contact First Name *
Your answer
Emergency Contact Last Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Relationship To Child *
Your answer
Please list any important medical information and/or food allergies for student:
Your answer
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