PARENT/CHILD DATA FORM
Parent's Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Number of Household Members
*
Annual Income
*
Child's Name
*
First Name
Last Name
Child's Birthdate
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
My child will be in the ______ grade next year. (Type the answer in the box)
*
Parent's E-mail
*
Parent's Signature
*
ANSWER THE QUESTIONS
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code (5 digits)
QUESTION 1
*
QUESTION 3
*
VOICE RECORDER: SUBMIT A RECORDING OF YOURSELF READING. (REQUIRED)
*
QUESTION 4
*
QUESTION 5
*
QUESTION 6
*
QUESTION 7
*
QUESTION 8
*
DESCRIBE WHAT STEPS YOU COMPLETED WITH BUILDING/CREATING YOUR WEBSITE ON TODAY. BE SURE TO INCLUDE THE DOMAIN NAME AND URL. (IF YOU DO NOT KNOW WHAT A URL REFERS TO YOU MUST RESEARCH TO FIND OUT).
*
0/100
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I HAVE THOROUGHLY PROOFREAD MY SUMMARY.
*
YES
NO
ALL SENTENCES ARE COMPLETE AND GRAMMATICALLY CORRECT. I USED PROPER CAPITALIZATION AND PUNCTUATION.
*
YES
NO
I ATTENDED THE ZOOM MEETING AT 8:30 AM TODAY.
YES
NO
HOW WOULD YOU RATE TODAY'S TASKS
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ALRIGHT
AWESOME
DISLIKED TOTALLY
Sentence 1
*
Sentence 2
*
Sentence 3
*
Sentence 4
*
Sentence 5
*
Sentence 6
*
Sentence 7
*
Sentence 8
*
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