Student Data Sheet printable pdf download

Student Data Sheet

BLUE MOUNTAIN SCHOOL DISTRICT

TITLE I

Serving the Needs of Parents and Students

BMEE BMEW

STUDENT DATA SHEET

Dear Parent(s),

In order for us to update our student records, we are asking that you provide us with the

following information.

Student’s Complete Name: _______________________________________________________

Grade Level: ____________________________ Building: ____________________________

Date of Birth: Month_______________________ Day______________ Year______________

Parent(s)/Guardian(s) Name: _____________________________________________________

Complete Address: _____________________________________________________________

_____________________________________________________________

Home Phone Number: _____________________ Work Phone Number: __________________

Cell Phone Number: ________________________

E-mail address: ________________________________________________________________

May we call you at work if necessary? YES__________

NO__________

Thank you for taking the time to complete this form. If we can be of any assistance

during the school year, please don’t hesitate to give us a call at your child’s building.

Mrs. Sondra Jones, Reading Specialist - BMEE

Mrs. Ann Lucarino, Reading Specialist - BMEE

Mrs. Kirstin Fitzpatrick, Reading Specialist - BMEW

Mrs. Diane Kerchner, Reading Specialist – BMEW

Student Data Sheet