|
Parents: Please complete this form (not to be completed by student) and return to guidance. Tiftarea Academy2009-2010Permanent Record Information Sheet Student's Name__________________________________________________________________Last First Middle Name Preferred________________________________________________________________ Student's Date of Birth____________________________________________________________Month Day Year Student's Social Security Number___________________________________________________(Please attach copy of social security card if not on file)Father's Name___________________________________________________________________ Mother's Name__________________________________________________________________ Live with: Both Parents ( ) Father ( ) Mother ( ) Other ( ) Brothers' and/or Sisters' Names and Grade____________________________________________ ______________________________________________________________________________ Home Address__________________________________________________________________Street__________________________________________________________________City State Zip__________________________________________________________________County of Residence Home Phone____________________________________________________________________ Father's Place of Employment______________________________________________________Work Phone______________________________Cell Phone______________________ Mother's Place of Employment_____________________________________________________Work Phone______________________________Cell Phone______________________ Parents’ E-mail address (not student) ______________________________________________ Doctor & Phone_________________________________________________________________ Allergies_______________________________________________________________________ Special Information______________________________________________________________ ______________________________________________________________________________
|
|
Last Updated ( Tuesday, 10 November 2009 )
|
Downloadable Forms