Student Change of Information Form

Please complete the form below. Required fields marked with an asterisk *

Student's First Name*

Answer required for "Student's First Name"

Student's Middle Name

Answer required for "Student's Middle Name"

Student's Last Name*

Answer required for "Student's Last Name"

Date Of Birth*

Needed for identification purposes

Answer required for "Date Of Birth"

Phone Number Change

Number Required

Email Address Change

Answer required for "Email Address Change"

Address Change

Street Address

Answer required for "Street Address"

Apt / Unit / Ste

Answer required for "Apt / Unit / Ste"

City

Answer required for "City"

Zip/Postal

Answer required for "Zip/Postal"

Change of addresses require proof of residency.

Answer required for "Change of addresses require proof of residency. "

Choose a file or drag it here.

Parent's First Name*

Answer required for "Parent's First Name"

Parent's Middle Name

Answer required for "Parent's Middle Name"

Parent's Last Name*

Answer required for "Parent's Last Name"

Relationship To Student*

Answer required for "Relationship To Student"

New Contact (Optional)

Contact's First Name

Answer required for "Contact's First Name"

Contact's Middle Name

Answer required for "Contact's Middle Name"

Contact's Last Name

Answer required for "Contact's Last Name"

Contact's Relationship To Student

Answer required for "Contact's Relationship To Student"

Contact's Phone Number

Number Required

Contact's Email Address

Answer required for "Contact's Email Address"

Is this an emergency contact?

Answer required for "Is this an emergency contact?"

Yes

Does this contact have custody of the student?

Answer required for "Does this contact have custody of the student?"

Yes

Does this contact live with the student?

Answer required for "Does this contact live with the student?"

Yes

May this contact receive mail on behalf of the student?

Answer required for "May this contact receive mail on behalf of the student?"

Yes

Should this contact receive announcements from the school?

Answer required for "Should this contact receive announcements from the school?"

Yes

To add additional contacts, submit this form and return to complete it again.

Signature*

Signature Required

Please fix the highlighted areas below before submitting.

Student Change of Information Form