Emergency Contact Information

- Academics
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    Student Handbook
    Back to School Forms
    
    Change of Address Form
    Emergency Contact Information
    
    Guidance Department
    Cafeteria/Lunch Information
    Course Offerings
    Graduation Requirements
    SHHS Summer School 2025

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- Please fill out student's information below.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Grade REQUIRED Please fill out this field. Please enter valid data.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Address REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Student Resides with: REQUIRED Mother Father Other (please specify below) Please fill out this field.
- If you indicated "Other", please specify who the child resides with below: Please enter valid data.
- Please fill our parent's information below:
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Business Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Business Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Emergency Contacts
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relationship Please enter valid data.
- Home Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Business Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Relationship Please enter valid data.
- Home Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Cell Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Business Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Form Filled out by: REQUIRED Please fill out this field. Please enter valid data.
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