Student Information
Name: _________________________________
I like to be called: _______________________
Primary Address:__________________________________ Home Phone: _____________________
I live with: ________________________________________________________________________
Parent/Guardian Name: ________________________ Day Phone: __________________________
Email: _____________________________
Parent/Guardian Name: ________________________ Day Phone: __________________________
Email: _____________________________
Who is the best person to contact during the day? ________________________________________
What is the best way to contact them (work phone, cell, e-mail, etc.)? ________________________
Emergency Contact: __________________ Phone: _______________ Relationship: _____________
My favourite subject is: ______________________________________________________________
I like science:
TRUE / FALSE
I would like to learn about: ____________________________________________________________
I think you should know_______________________________________________________________
Any Health Issues? ___________________________________