Student'S Physical Form - Wenatchee High School Athletic Department, Washington printable pdf download

Do N ot B end

WHS 2 /13

GENERAL I NFORMATION

STUDENT’S N AME _ ___________________________________________________________________________________

(Last N ame)

(First N ame)

(Middle I nitial)

PARENT/GUARDIAN _ _______________________________________________________________________________

(Last N ame)

(First N ame)

PARENT/GUARDIAN _ ________________________________________________________________________________

(Last N ame)

(First N ame)

HOME A DDRESS _ _______________________________________________ C ITY _ _______________________________

AGE _ _____________________ GRADE _ _________________

ANSWER A LL O F T HE F OLLOWING Q UESTIONS W ITH Y ES O R N O:

_________

Are y ou c urrently l iving w ith y our p arent(s)?

_________

If n o, a re y ou l iving w ith y our l egal g uardian?

_________

Are y ou c urrently l iving w ithin t he W enatchee S chool D istrict b oundaries?

_________

Are y ou n ow o r h ave y ou e ver b een a f oreign e xchange s tudent?

_________

If y es, h ave y ou g raduated f rom y our e quivalent s chool?

_________

Were y ou a t ransfer s tudent l ast y ear?

If y es, w hat w as t he d ate o f y our e ntrance t o t he W enatchee S chool D istrict? _ ____/______/________

m o/day/year

Do y ou a ttend:

_______ Westside H igh S chool

_______ Skill S ource

_______ Skills C enter

_______ Running S tart

_______ Home S chool / R iver A cademy

_______ Private S chool

Private S chool N ame _ _______________________________

If y ou D ID N OT a ttend W enatchee S chools l ast y ear, w hat s chool d id y ou a ttend:

Name o f S chool _ ________________________________________________

_____________________________________

(Date W ithdrew)

Location o f S chool _ ____________________________________________

______________________________

(City)

(State)

-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐-‐

Office U se:

FALL

WINTER

SPRING

ALL Y EAR

ASB _ ______

_______

BBB

_______

GBB

_______

GSO