Change to Student Information Form

*This form is accessible via mobile devices. However, desktop devices are best for optimal functionality. An inoperative “submit” button indicates that some form fields are missing or typed incorrectly. Desktop devices will describe any necessary corrections that hinder submissions, but mobile forms do not have this function.

Parent Name (First and Last)

Student Name (First and Last)

Today's Date MM/DD/YYYY

Choose one or more of the following options.

I need to:

Update Items

Change my Address, Phone Number, or Email on File Update Custody Information Inform the school of a recent or upcoming hospitalization that may effect their typical school day Inform the school about other changes (sleep, medications, life changes, etc.) Inform the school about recent evaluations Submit updated documents Other

If "Other" selected, specify here:

1.) If you have a new ADDRESS, PHONE and/or EMAIL, ***enter the new information below:***

New Contact Info:

2.) If you would like to inform the school about any changes that may affect your child's school day (hospitalizations, sleep patterns, home medications, life changes, etc.) please enter below. Please also complete the Student Absence Form for any planned vacations, hospitalizations, or other absences scheduled during the school week.

New Home Info:

3.) If you would like to upload any new documents for the school to keep on file, please do so below (custody, evaluations, action plans, immunizations/physicals, etc.) You may upload multiple files.

New Documents

Document Notes:

Parent E-Signature (First, MI, Last)

Change to Student Information Form

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