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General Student Demographics Form (Elementary)

Please complete the form below. Required fields marked with an asterisk *

Student LAST Name*

Answer required for "Student LAST Name"

Student FIRST Name*

Answer required for "Student FIRST Name"

Student MIDDLE Initial*

Answer required for "Student MIDDLE Initial"

Student's Physical Address

Street Address*

Answer required for "Street Address"

City*

Answer required for "City"

Zip/Postal*

Answer required for "Zip/Postal"

Mailing Address (if different from physical address)

Answer required for "Mailing Address (if different from physical address)"

Home Phone Number*

Number Required

Student's Date of Birth*

Answer required for "Student's Date of Birth"

Parent(s) or Legal Guardian's Name*

Answer required for "Parent(s) or Legal Guardian's Name"

The parents are

Answer required for "The parents are"

living in the same home.

separated.

divorced.

Which parent has legal, physical custody of the student?*

Answer required for "Which parent has legal, physical custody of the student?"

If the student's parents/guardians are separated or divorced, are custody papers on file with the school?

Answer required for "If the student's parents/guardians are separated or divorced, are custody papers on file with the school?"

Yes

Not applicable

Father's Name (First and Last)

Answer required for "Father's Name (First and Last)"

Father's Preferred Phone Number

Answer required for "Father's Preferred Phone Number"

Father's Mailing Address

Answer required for "Father's Mailing Address"

Father's Employer

Answer required for "Father's Employer"

Mother's Name (First and Last)

Answer required for "Mother's Name (First and Last)"

Mother's Preferred Phone Number

Answer required for "Mother's Preferred Phone Number"

Mother's Mailing Address

Answer required for "Mother's Mailing Address"

Mother's Employer

Answer required for "Mother's Employer"

Please list any siblings and include grade level if school aged.

Answer required for "Please list any siblings and include grade level if school aged. "