Student Information Sheet
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1Student Name: ________________________________ I.D. No. # ________________
Address: ______________________________________________________________
Home Phone: (______)___________________________________________________
Date of Birth: ____/______/_____
Medical Info. : ___________________________
Name:
Work Address
Work Number
Mother:
(
)
Father:
(
)
Guardian
(
)
Emergency Persons
Name:
Address:
Phone:
Relation:
(
)
1.
(
)
2.
Test Scores:
Subject:
Total Reading
Reading Compr.
Total Math
Language
Grade Level :
National % :
Communication with parents:
Date:
Reason:
Results/Comments:
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Parent category: Business