Student Information Sheet Child’s Name ____________________________Preferred Name__________________ Parents’/Guardians’ Names: __________________________________________ __________________________________________ Child’s Birthday: ____/____ /____

Home Address _____________________________________________________ Home Phone Number: (____) ____-________

Please star best way to contact you!

Mother’s: Work # (____) ____-________ Father’s: Work # (____) ____-________ Cell # (____) ____-________ Cell # (____) ____-________ Email _____________________ Email ____________________

Emergency Name ________________________ Phone Number (___) ____-_________ Siblings in district:

My child will:

Name ____________________ ____________________ ____________________

Grade ______ ______ ______

Teacher ________________ ________________ ________________

[ ] ride the ______________ bus daily. (name/# of bus) [ ] be picked up daily by _________________

Allergies/Medical Problems: ________________________________________________________________ ________________________________________________________________ Religious Restrictions, if any (example: holidays) _______________________________________

Please tell me anything else you think I should know about your child, social or academic. Thank you! ______________________________________________________________ ______________________________________________________________ Copyright The Owl Teacher 2014