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Parent Information Form


Dear Parents,

I am attempting to use e-mail to contact you and allow you to contact me in a more accessible manner. Please fill out this form and submit it so that I may use this information to correspond with you regarding your child.

Student Information:

 
Student Name E-mail
Class:
Class Period:
Parent (1) Information:
 
Name
Address
Zip
Home Phone E-mail
Work Phone website
Parent (2) Information:
 
Name
Address
Zip
Home Phone E-mail
Work Phone website

NOTE: By submitting this form you agree that I may use this information to contact you in regards to your child.  This form is being submitted via e-mail.  Your browser may state that this is a security risk.  I will not be selling your e-mail address, and I will not give out your address to anyone else unless you ask me to.
         - D. Goettman


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