Communications Form
Name:
__________________________________________________________________
(Last) (First) (MI)
Address:
__________________________________________Zip Code: _______________
SSN:________________________________
Date of Birth: ________________________
Advisory:
______________Locker #: ___________
Combination: ____________________
Transportation
Home: Car ____________
Clubs
– After School Meetings: ________________________________________________
HOME
PHONE: ____________________________
Father’s
Name: _____________________________ e-mail: _________________________
Work #:
________________________________ Cell #:
_________________________
Mother’s
Name: ____________________________ e-mail: _________________________
Work #:
________________________________ Cell #:
_________________________
Describe any
medical/physical condition your child may have: __________________________
_______________________________________________________________________
Allergies:
________________________________________________________________
Does your child
wear glasses or contacts – for reading or board work
(Circle) (Circle)
Ø
Yes, I am aware of the school’s website and will use it to email
my child’s teachers and to access daily lessons: http://www.germantownms@scs.k12.tn.us
Or, I can access
the school’s website through the Shelby County Schools site be clicking on
schools, and then selecting middle schools, then
My
email address is: _______________________________________________________
____________________________________________________
Parent signature/date signed
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Shelby County
Schools offers educational and employment opportunities without regard to race,
color, national origin, religion, sex, or disabilities.