Student Change Of Information Form

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

Student's First Name*

Answer Required

Student's Middle Name

Answer Required

Student's Last Name*

Answer Required

Date Of Birth*

Needed for identification purposes

Answer Required

Phone Number Change

Number Required

Email Address Change

Answer Required

Address Change

Street Address

Answer Required

Apt / Unit / Ste

Answer Required

City

Answer Required

Zip/Postal

Answer Required

Change of addresses require proof of residency.

Answer Required

Choose a file or drag it here.

Parent First Name*

Answer Required

Parent Middle Name

Answer Required

Parent Last Name*

Answer Required

Relationship To Student*

Answer Required

New Contact (Optional)

Contact First Name

Answer Required

Contact Middle Name

Answer Required

Contact Last Name

Answer Required

Contact's Relationship To Student

Answer Required

Contact's Phone Number

Number Required

Contact's Email Address

Answer Required

Is this an emergency contact?

Answer Required

Yes

Does this contact have custody of the student?

Answer Required

Yes

Does this contact live with the student?

Answer Required

Yes

May this contact receive mail on behalf of the students?

Answer Required

Yes

Should this contact receive announcements from the school?

Answer Required

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