I would like you to provide me with current contact information so that I may contact you if necessary during the school year. All information is kept confidential. Please print legibly.

Student’s Name: ____________________________________________

Parent’s Name/s: ____________________________________________

Home Phone: (        ) _________________________________________

Cell Phone:     (       ) _________________________________________

E-mail: ____________________________________________________

          Please print legibly

Thank you for your cooperation,

Mrs. Savage