Name of Student ________________________________ Block ________ MS. GRIGGS

advertisement

Name of Student ________________________________ Block ________ MS. GRIGGS

Parent/Guardian 1: Name:_____________________________________________________________ Relationship to student:________________________________________________ Best phone number to reach you at during the day: __________________________ Circle one: Is it a cell phone home phone work phone Parent/Guardian 2: Name:_____________________________________________________________ Relationship to student:________________________________________________ Best phone number to reach you at during the day: __________________________ Circle one: Is it a cell phone home phone work phone

*IMPORTANT*

Is there any illness, disability, behavior issue, etc that I, as a teacher, need to be aware of to better serve your child? (Examples: dyslexia, ADD, poor eyesight or hearing, etc) _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________

Please read and sign the following...

“I have read and understand the policies set forth in Ms. Griggs’ syllabus and understand that I will be held accountable to them as well as to all policies set forth by Anderson 5 Career Campus.”

_________________________________________________ Student Signature _________________________________________________ Student Name (Print) _________________ Date _________________________________________________ _________________ Parent/Guardian Signature Date _________________________________________________ Parent/Guardian Name (Print)

Download