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Class of 2022
I.S. 24 7th grade student information form
* Indicates required question
Student's Class #
*
Your answer
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Student Date of Birth
*
MM
/
DD
/
YYYY
Parent's Last Name
*
Your answer
Parent's First Name
*
Your answer
Parent E-mail Address
*
Your answer
Home Address
*
Your answer
Home Phone/Alternate Phone
*
Your answer
Parent's Cell Phone
*
Your answer
Emergency Contact Name (First Person)
*
Your answer
Emergency Contact Relationship to Student (First Person)
*
Your answer
Emergency Contact Phone Number (First Person)
*
Your answer
Emergency Contact Name (Second Person)
Your answer
Emergency Contact Relationship to Student (Second Person)
Your answer
Emergency Contact Phone Number (Second Person)
Your answer
Name of any person your child should NOT be released to (if applicable)
Your answer
If you responded to the above question, is there an order of protection against this person?
Yes
No
Are there any allergies or medications your child has that we need to be aware of? If so, what are they?
Your answer
Any additional information you would like to share about your child
Your answer
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