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Family Involvement Form
Must be filled out completely.
true
Please enter the Parent/Family member information.
Parent / Family First Name
(Required)
true
Parent / Family Middle Name
true
Parent / Family Last Name
(Required)
true
Parent / Family Relation to Student
Please choose
Parent
Grandparent
Sibling
Guardian
Other
true
Address
(Required)
true
City
(Required)
true
State
(Required)
true
Zip Code
(Required)
true
E-mail
(Required)
true
Phone Number
(Required)
true
Alternative Phone Number
true
Add a Second Parent/Family member
Second Parent / Family Relation to Student
Please choose
Parent
Grandparent
Sibling
Guardian
Other
true
Second Parent / Family First Name
(Required)
true
Second Parent / Family Last Name
(Required)
true
Second Parent / Family E-mail
true
Second Parent / Family Phone Number
true
Second Parent / Family Alternative Phone Number
true
Please enter the Students Information.
Student First Name
(Required)
true
Student Middle Name
true
Student Last Name
(Required)
true
Date of Birth
(Required)
Format: mm/dd/yyyy
true
Student ID
true
Student E-mail
true
Student Phone Number
true
Student Alternative Phone Number
true
Referral Code (optional)
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