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2014-15 Student Contact & Health Information Verification Forms

Pre-Populated Forms will be Sent Home for Verification
MAKE UPDATES DIRECTLY ON THE FORMS & SIGN BOTH FORMS
RETURN to your Student's School by SEPTEMBER 9th

Click the following links to preview blank information forms & the information requested:

Student Contact Form
Student Health Form

Online Updating will not be available

The following information is to help guide you when updating your pre-populated paper form.  
Please provide any changes in information by writing directly on the form.  If you will be changing Contact Information, cross out the invalid contact & put the new information on the back of the form.

  • Information found on your child's birth certificate or requiring a legal document (Legal Guardian or Custody) can only be changed by contacting your child's school office.
    • Legal Guardian: relationship established by the court where one person acts for the benefit and protection of another person
    • Custody: is granted to one or both parents of a child.  In contrast, a legal guardian is not the parent of the child.
       
  • To determine your child's ethnic code, please refer to the Department of Education link below:
    Download the DOE Ethnic Code Definition Table
     
  • Hospital Preference: Legally we are only allowed to transport you child to a local hospital.  Please select from the following:
    • Anna Jaques
    • Merrimack Valley
    • Holy Family
    • Lawrence General
    • Nearest (Any)
       
  • Military Family Description: Students who are children of:
    • Active duty members of the uniformed services, National Guard and Reserve on active duty orders
    • Members or veterans who are medically discharged or retired within one year
    • Members who die on active duty
      ‚Äč
  • Contact Code Descriptions:
    • C1 = Primary Contact 1 - The Parent / Guardian at the student's residence
    • C2 = Primary Contact 2 - The 2nd Parent / Guardian or non-custodial parent
    • C3 = Emergency Contact 1 - The first emergency contact (not primary 1 or 2)
    • C4 = Emergency Contact 2 - The second emergency contact (not primary 1 or 2)

Additional Resources

WN Mosquito Spraying Announcement - NE Mosquito Control

 For school specific resources for parents, please visit the individual school website.