Course _______________________
Period ______
STUDENT INFORMATION
NAME ____________________________________________Homeroom/Advisor _____________________
Mailing Address (street AND city)___________________________________________________________
Student’s Email address
____________________________________ Home / Cell Phone ______________
Parents' Names__________ ____________________ Parents’ Email Address _________________________
Name of guardian (if not living with parents): ___________________________________________________
Person to contact if there is an emergency/problem: _____________________________________________
Relationship _______________________ Telephone number__________________________________
This Semester's Schedule
1. __________________________________ Teacher _________________________________
2. __________________________________ Teacher _________________________________
3. _________________________________ Teacher _________________________________
4. __________________________________ Teacher _________________________________
Describe any unusual health conditions you may have:
List after school activities in which you participate: (sports, band, work, etc.)____________________________
______________________________________________________________________________________
Complete the following:
I like to read …
My favorite subject is ….
The proudest I've been was …
The luckiest I've been was
The biggest mistake I've made was …
What is a story from your own life or your ancestors'
lives that you are likely to pass along to younger
generations?
What else should I know about you?