SCHOOL START-UP INFORMATION

Rockdale Magnet School for Science and Technology



Must be completed by parent/guardian


If you have more than one RMSST student, please complete a separate questionnaire for each student.


If a REQUIRED question is not applicable, please enter N/A.


A red asterisk (*) indicates required questions.

  1. Student's Grade Level for the 2013-14 school year  *


  1. Student's LAST name*


  1. Student's FIRST name *


  1. Student's MIDDLE name *


  1. Student's PREFERRED name (How would he/she like to be addressed at school?)*


  1. Student's Birthdate (xx/xx/xx)*


  1. Student's Street Address *


  1. City*


  1. Zip Code*


  1. Student's current school zone   *


  1. Student lives with (check all that apply)*
    Father
    Mother
    Stepfather
    Stepmother
    Guardian other than Parent or Stepparent


  1. Name(s) of parent(s)/stepparent/guardian(s) with whom student lives*


  1. Student's Home Phone Number (xxx-xxx-xxxx)*


  1. Student's Mobile Number - if applicable (xxx-xxx-xxxx)


  1. Parent/Stepparent/Guardian's Mobile Number(s)
    List all numbers that may receive school-related calls.
    Example:
    Father: xxx-xxx-xxxx
    Mother: xxx-xxx-xxxx


  1. Parent/Stepparent/Guardian's Work Number(s)
    List all numbers that may receive school-related calls. *


  1. Student's Email Address*


  1. Father's Email Address #1 (Please only include email addresses that may receive school-related emails.)*


  1. Father's Email Address #2


  1. Mother's Email Address #1 (Please only include email addresses that may receive school-related emails.)*


  1. Mother's Email Address #2


  1. Father's Occupation and Employer


  1. Mother's Occupation and Employer


  1. Name of Emergency Contact Person*


  1. Emergency Contact Person's Phone Number (xxx-xxx-xxxx)*


  1. The following people are authorized to check out my student during the school day.
    Please list the names of parents, stepparents, guardians, and any other people who have the authority of the student's legal guardians.

    PLEASE NOTE: In the interest of safety, students will only be released to people on this list. Everyone on the list must be prepared to show picture ID at the time of check out.*


  1. Student's T-shirt size*
    Adult Small
    Adult Medium
    Adult Large
    Adult X-Large
    Adult XX-Large


  1. Any additional information about your student that would be beneficial to RMSST staff