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Change of Information Form

Required

Student Information

Namerequired
First Name
Last Name
Must contain a date in M/D/YYYY format
Grade Levelrequired

Custodial Information

With whom does the child reside:
Type of custody:***(Please provide court documentation, which must be on file with the school to be enforceable)***
***(Please provide court documentation, which must be on file with the school to be enforceable)***

Contact Information

Please list the parent that should be contacted first and second for attendance/nurse calls

Primary Contact

Namerequired
First Name
Last Name

Secondary Contact

Namerequired
First Name
Last Name

Emergency Information

Please give the names and phone numbers of two individuals other than yourself who have permission from you to be contacted and requested to pick up your child in case of an emergency:
1. Namerequired
First Name
Last Name
2. Namerequired
First Name
Last Name
Please upload two proofs of residency
Attach up to 2 files with a maximum size of 10MB
No file chosen
Attach up to 2 files with a maximum size of 10MB
No file chosen