HUGULEY ELEMENTARY SCHOOL
HUGULEY ELEMENTARY SCHOOL
STUDENT REGISTRATION
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|Social Security Number: - - . Home Phone Number: ________________ |
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|Child's Name _____________________ ___________________________ _________________ |
|Last First Middle |
|Street Address: ___________________________________ City: _______________________ |
|P.O. Box: _________________________________________ City: _______________________ |
|Race: ______________ Sex: Female χ Male χ Date of Birth: ______________________ |
| |
|χFather or χguardian/ Name: ______________________________________________________ |
| |
|Address: ______________________________________________________________________ |
|(If different from address given above) |
|Phone Number: ___________________________ Cell Phone Number: ______________________ |
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|Employer: ______________________________ Work Phone # __________________________ |
| |
|Child lives with: χMother χFather χBoth Parents χGuardian ____________________(relationship) |
| |
|χMother or χ Guardian/ Name: _____________________________________________________ |
| |
|Address:_______________________________________________________________________ |
|(If different from address given above) |
|Phone Number: ___________________________ Cell Phone Number: ______________________ |
| |
|Employer: ______________________________ Work Phone # ___________________________ |
|List of people with permission to sign your child out of school. |
|(These people will be contacted in cases of emergency when parent/guardian cannot be reached.) |
| |
|Name: ____________________________ Phone numbers: _____________________________ |
| |
|Name: ____________________________ Phone numbers: _____________________________ |
| |
|Name: ____________________________ Phone numbers: _____________________________ |
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|Doctor: ____________________________ Phone number: ______________________________ |
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|Medical Problems: _______________________________________________________________ |
|_____________________________________________________________________________ |
|Method of Transportation: χ Car χ Day Care __________________ χ School Bus # __________ |
| |
|Last school attended (If other than Huguley Elementary): Name: _____________________________ |
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|City: ____________________________ State: _______________________________________ |
|Chambers County Board of Education enrolls immigrant, ESL, homeless, or migrant students regardless of proof of residency requirements. |
IF YOUR CHILD TAKES MEDICATION, PLEASE OBTAIN A MEDICATION FORM FROM THE OFFICE.
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