School Emergency Messaging System Test
Part 2: Printable Parent / Guardian Contact Update Form
Student Full Name
First Name
Last Name
Grade & School Building
Parent / Guardian 1 Name
First Name
Last Name
Primary Phone Number
Format: (000) 000-0000.
Mobile Phone (for Text Alerts)
Format: (000) 000-0000.
Primary Email Address
example@example.com
Parent / Guardian 2 Name (Optional)
First Name
Last Name
Secondary Phone Number
Format: (000) 000-0000.
Secondary Email Address
example@example.com
Alert Preferences:
• Voice Call Notifications:
Yes
No
• SMS Text Message Alerts:
Yes
No
• Email Announcements:
Yes
No
Parent / Guardian Signature:
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Preview PDF
Submit
Should be Empty: