JCHS Student Data for 2010-2011 - NEW STUDENTS

1. Student Information

Thank you for taking time to complete the JCHS summer data for the academic year 2010-2011. The online forms and release must be completed and submitted before MONDAY, AUGUST 2, 2010. If you have multiple students attending JCHS, please submit separate data for each student.

Please contact Office Manager David Joseph at 415.345.9777 x100 or djoseph@jchsofthebay.org with any questions. Please note that JCHS will be closed for the week of July 4.

Question Title

Student Information

Student First Name

Preferred Name (if different from Student First Name)

Middle Name

Last Name

Address

Address 2

City

State

Zip

Home Phone

Student Cell Phone

Student E-mail

Question Title

Does this student have relatives attending JCHS? If so, please list their names, ages and relation to student.

Question Title

Parent/Guardian 1 Information

Parent/Guardian 1 Prefix

Parent/Guardian 1 First Name

Parent/Guardian 1 Middle Name

Parent/Guardian 1 Last Name

Relationship to student

Occupation

Address (if different from student)

Address 2

City

State

Zip

Parent/Guardian 1 Home Phone(if different from student)

Parent/Guardian 1 Cell Phone

Parent/Guardian 1 Work Phone

Parent/Guardian 1 E-mail

Question Title

Parent/Guardian 2 Information

Parent/Guardian 2 Prefix

Parent/Guardian 2 First Name

Parent/Guardian 2 Middle Name

Parent/Guardian 2 Last Name

Relationship to student

Occupation

Address (if different from student)

Address 2

City

State

Zip

Parent/Guardian 2 Home Phone

Parent/Guardian 2 Cell Phone

Parent/Guardian 2 Work Phone

Parent/Guardian 2 E-mail

Question Title

Parent/Guardian 3 Information

Parent/Guardian 3 Prefix

Parent/Guardian 3 First Name

Parent/Guardian 3 Middle Name

Parent/Guardian 3 Last Name

Relationship to student

Occupation

Address (if different from student)

Address 2

City

State

Zip

Parent/Guardian 3 Home Phone(if different from student)

Parent/Guardian 3 Cell Phone

Parent/Guardian 3 Work Phone

Parent/Guardian 3 E-mail

Question Title

Grandparent Information
JCHS likes to include grandparents in celebrations, fundraising efforts, and communications about events at school. If you would like JCHS to share this information with them, please complete the information below.

(a) Grandparent Full Name (Family 1)

Grandparent Full Name (Family 1)

Address

City

State

Zip

Home Phone

E-mail

(b) Grandparent Full Name (Family 2)

Grandparent Full Name (Family 2)

Address

City

State

Zip

Home Phone

E-mail

Question Title

If there are any other relatives or significant people in your student's life whom you would like to be included, please complete the information below.

Name

Address

City

State

Zip

Relationship to student

Home Phone

E-mail

Question Title

Student Information

Question Title

Does this student have relatives attending JCHS? If so, please list their names, ages and relation to student.

Question Title

Parent/Guardian 1 Information

Question Title

Parent/Guardian 2 Information

Question Title

Parent/Guardian 3 Information

Question Title

Grandparent InformationJCHS likes to include grandparents in celebrations, fundraising efforts, and communications about events at school. If you would like JCHS to share this information with them, please complete the information below.

Question Title

If there are any other relatives or significant people in your student's life whom you would like to be included, please complete the information below.

Grandparent Information
JCHS likes to include grandparents in celebrations, fundraising efforts, and communications about events at school. If you would like JCHS to share this information with them, please complete the information below.