Merrick Student Information Form

Updated Student Information

It is important that Merrick Academy has your child's current information on file. If your home address, email, or phone number has changed from the beginning of the school year, please fill out this form.

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* 1. Student Name (last name, first)

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* 2. Student OSIS number or Grade

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* 3. Parent's Name

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* 4. What information is new ?

Email address

Home address

Phone Number

Other

Question Title

* 5. Please provide the new information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 6. Is the information provided above a permanent change or temporary change?

The new information is permanent

The new information is only temporary

Merrick Student Information Form

Updated Student Information

Question Title

* 1. Student Name (last name, first)

Question Title

* 2. Student OSIS number or Grade

Question Title

* 3. Parent's Name

Question Title

* 4. What information is new ?

Question Title

* 5. Please provide the new information

Question Title

* 6. Is the information provided above a permanent change or temporary change?

Question Title

* 7. If temporary, please explain.