Last Name _______________ First Name __________ Middle I. ___
Home Phone______________ Emergency Phone ________________
Birthday ____________ (please include year)
Parent or Guardian _________________ Relationship: ___________
Home Address ____________________________________________
City ____________ State _____ Zip Code ____________
E-Mail Address __________________________
Homeroom Teacher _______________________
Favorite Color ______________ Favorite Candy __________________
Favorite Soda ______________
Hobbies ___________________________________________________
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What is your favorite subject? _________________________________
What do you want your teacher to know about you? ________________
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