QUESTIONNAIRE FOR A GREATER UNDERSTANDING OF YOU AND YOUR STUDENT

Students Name Parent/Guardian/Primary Caregivers Name(s) Parent/Guardian/Caregivers HOME Phone Number Parent/Guardian/Caregivers CELL Phone Number Parent/Guardian/Caregivers WORK Phone Number Parent/Guardian/Caregivers Email Address(es) 1._____________________________________________________________ 2._____________________________________________________________ The BEST time to contact Parent/Guardian/Caregiver is: ___8am-12 noon
____12

What should the instructor(s) know/be aware of regarding your child?

noon-5pm ___5pm-9pm

The BEST way to contact Parent/Guardian/Caregiver is: ___Call Home phone number ___Call Cell phone number ___Call Work phone number ___Contact via e-mail

Are there any questions or concerns regarding this class or its policies and procedures?

I have read the course description with my child/student and am aware of class policies and procedures. ___________________________________________________________
Signature of Parent/Guardian/Caregiver

___________________________________________________________
Signature of Parent/Guardian/Caregiver