Communications Form

 

Name: __________________________________________________________________

               (Last)                                                                          (First)                                           (MI)

Address: __________________________________________Zip Code: _______________

SSN:________________________________ Date of Birth: ________________________

Advisory: ______________Locker #: ___________  Combination: ____________________

Transportation Home:  Car ____________  Walker ____________ Bus Route # __________

Clubs – After School Meetings: ________________________________________________

HOME PHONE: ____________________________

Father’s Name: _____________________________ e-mail: _________________________

   Work #: ________________________________  Cell #: _________________________

Mother’s Name: ____________________________ e-mail: _________________________

   Work #: ________________________________  Cell #: _________________________

Medical Information

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 Germantown Middle School.

My email address is: _______________________________________________________

                                      ____________________________________________________

                                                                                Parent signature/date signed

 

Date

Time

Comments

 

 

 

 

 

 

 

 

 

 

 

 

Shelby County Schools offers educational and employment opportunities without regard to race, color, national origin, religion, sex, or disabilities.