Please fill out all fields, do not leave any blanks, if a field does not apply to you then type in the word "none."
Once you complete all fields hit submit. Then print out the permission slip that appears.
You and your parents/guardian must sign and return this part to me.
Thank you

 

Student Name Grade ID

 

Father/Guardian

 

Mother/Guardian

 

Contact Information	Home phone	Work phone	Cell phone
Father/ Guardian
Mother/ Guardian

 

 

 

 

 

 

 

 

Contact Information	Home email	Work email
Father/ Guardian
Mother/ Guardian
Student
Password for grade check (6 to 12 characters)

Gender: Male
Female

Primary Language English Other

I have internet access at home: Yes
No