Directory Information Form

Only one form per family needs to be completed. This form should only be completed by the custodial parent/legal guardian living with the child(ren). Please complete information exactly as you would like it to appear in the Directory. Selected information, per your approval, can be included in the Directory. If you would like to include such information, please check the approval to publish box.

Student 1

Student 1 Last Name: *

Student 1 First Name: *

as to appear in the directory

Student 1 Middle Name:

Student 2

Student 2 Last Name:

Student 2 First Name:

as to appear in the directory

Student 2 Middle Name:

Student 3

Student 3 Last Name:

Student 3 First Name:

as to appear in the directory

Student 3 Middle Name:

Student 4

Student 4 Last Name:

Student 4 First Name:

as to appear in the directory

Student 4 Middle Name:

Custodial Parent(s)/Legal Guardian(s)

Father/Guardian Last Name:

Father/Guardian First Name:

Mother/Guardian Last Name:

Mother/Guardian First Name:

Formal Salutation:

(ex. Mr. and Mrs. Joe Smith)

Address

Street Address: *

City: *

State: *

Zip: *

Contact

Primary Email: *

Primary Email Type: *

Primary Phone: *

Without spaces or dashes

Primary Phone Type: *

Additional Contact Information

Additional Email:

Email Type:

Publish in Directory:

Additional Phone:

Without spaces or dashes

Additional Phone Type:

Publish in Directory:

Non-Custodial Parent(s)

(if applicable)

Father Last Name:

Father First Name:

Publish in Directory:

Mother Last Name:

Mother First Name:

Publish in Directory:

Formal Salutation:

(ex. Mr. and Mrs. Joe Smith)

Non-Custodial Parent Address

if applicable

Street Address:

City:

State:

Zip:

Publish in Directory:

Directory Information Form

Grace News

Grace Events