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rr math student survey | monitoring

 

Student Information Form

Name:

Email:

ID#

Age: Grade:

Birthdate (mm/dd/yy):

Parent or Guardian Name(s):

Mailing Address:

City, Zip:

Contacts

To Reach: self

Phone # home work message

To Reach: father/
step father/foster

Phone # home work message

Email

To Reach: mother/
step mother/foster mother

Phone # home work message

Email

To Reach: other

Phone # home work message

Email

 
Schedule
Period
Course Title
Teacher
Email
Room

1

2

3

4

5

6

7

8

9

Do you need to clarify any of the information above? For example are there certain times that it is best to call you or your parent at home?

Is there anything that you would like for us to know about you or your schedule?

If so write us a note in the field below.

 

Print a hard copy of this form before sending to teacher!!!!

 

 

© 2002, Jean Ella