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Student Information Sheet Mr. York - World Geography - World History

This document contains a student information sheet collecting details about a student such as their name, address, class schedule, locker information, extracurricular activities, and contact information for parents. It also includes a log to track communication between teachers and parents regarding circumstances such as absences, academic performance, behavior, and notes from any meetings or calls.

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api-285532109
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© © All Rights Reserved
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58 views4 pages

Student Information Sheet Mr. York - World Geography - World History

This document contains a student information sheet collecting details about a student such as their name, address, class schedule, locker information, extracurricular activities, and contact information for parents. It also includes a log to track communication between teachers and parents regarding circumstances such as absences, academic performance, behavior, and notes from any meetings or calls.

Uploaded by

api-285532109
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 4

Do not write in

this section.

Returned Forms: Class/Dept. Guidelines

Plagiarism Statement

STUDENT INFORMATION SHEET (please PRINT clearly)


Mr. York
(Check one) World Geography World History
Name:

Birthday:

Address:

Phone #:

City, State, ZIP Code:


I live with my:
Father/Guardian

Mother/Guardian

Name:
first

last

first

last

Workplace:
Work phone #:
Cell phone #:
E-mail address:

PERIOD

CLASS

CLASS SCHEDULE
ROOM #

TEACHER

1
2
3
4
5
6
7
8
Locker Number

Locker Combination

School attended last year

Teacher name

Extracurricular Activities (band, agriculture, volleyball, football, swimming, pep squad, debate, etc.):
Activity

Sponsor/Coach

Activity

DATE
Date:

Time:

Date:

Time:

Date:

Time:

Date:

Time:

Date:

Time:

CIRCUMSTANCE

Sponsor/Coach

NOTES

COMMUNICATION

COMMENTS

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

conference with student


email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

Date:

Time:

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

Contact Information
Student/Parent
Communication
DATE
CIRCUMSTANCE
NOTES
Date:

Time:

Date:

Time:

Date:

Time:

Date:

Time:

Date:

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________
accepted until __________ max grade ____
other:

Name _______________________________
COMMUNICATION

COMMENTS

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

conference with student


email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure

student conference
email
letter home
office referral

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

Time:

Date:

Time:

Date:

Time:

low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

phone call @ home


work
mother father
guardian
message no answer
other:

assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

absence notification
academics
dishonesty
failing/failure
low grade
missing assignment(s)
progress report
behavior/discipline
response to parent
contact
other

student conference
email
letter home
office referral
phone call @ home
work
mother father
guardian
message no answer
other:

discussed resolved continuing


conference requested _________________
grade penalty -N.C. -11 -22 -33
-50
assignment _________________________

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

accepted until __________ max grade ____


other:

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