Student Information Sheet
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1STUDENT INFORMATION SHEET
Franklin High School
2011-12
Student Name: ______________________________________________________________________
Last
First
MI
DOB:__/___/____
G
: M
F
Home Language___________
ENDER
ALE
EMALE
Hispanic or Latino
Not Hispanic, Not Latino
Ethnicity:
American Indian or Alaska Native
Asian
Black or African American
Race:
White
Hawaiian or Other Pac. Islander
Nationality:
PARENT/GUARDIAN INFORMATION
BOTH Parents
MOTHER
FATHER
OTHER_________
The student lives with:
Parent/Guardian 1:______________________________________________
Physical Address:________________________________________________________________________________
Mailing Address if different:________________________________________________________________________
Home Phone: ____________________________________________________
Work Phone: ____________________________________________________
Cell Phone:
____________________________________________________
Email:
____________________________________________________
Parent/Guardian 2:______________________________________________
Physical Address:________________________________________________________________________________
Mailing Address if different:_________________________________________
Home Phone: _____________________________________________________
Work Phone: _____________________________________________________
Cell Phone: _____________________________________________________
Email:
_____________________________________________________
Phone Numbers to be called in the case of school cancellation/early dismissal/school emergency:
Phone: ___________________________________
Phone: ___________________________________
Emergency Student Contact: In case of accident or injury to student:
Name:____________________________________
Phone:____________________________________
It is extremely important that contact information be up to date. Please make sure that the school office is
notified of any changes in this information.
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