EMERGENCY CONTACT INFORMATION
ALL MATERIALS MUST BE SUBMITTED BY MAY 9, 2026
Student Name
*
First Name
Last Name
Student cell phone number
*
-
(000)
000-0000
Student Email
*
(personal email – not a school email)
Parent / Guardian Name(s)
*
Mother/Guardian phone number
*
-
(000)
000-0000
Mother/Guardian cell phone number
*
-
(000)
000-0000
Mother/Guardian email
*
Father/Guardian phone number
*
-
(000)
000-0000
Father/Guardian cell phone number
*
-
(000)
000-0000
Father/Guardian email
*
In the space below, please provide at least one emergency contact for the student.
Emergency Contact Name
*
First Name
Last Name
Relationship to Student
*
Emergency Contact Email
*
example@example.com
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Other Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
LEARNING ABOUT BUSINESS
391 W. WASHINGTON ST. • PAINESVILLE, OHIO 44077 440-375-7185 info@learningaboutbusiness.org www.learningaboutbusiness.org
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