Parent/Guardian & Student Signature Page
The Parent'Student Handbook is available on-line at: http://www.lowell.k12.ma.us
By signing below, I acknowledge I have accessed the school handbook, and I acknowledge that my child is responsible for adhering to these policies and may face consequences for failing to comply.
Student's Name (Print): _______________________________________
ID Number: ___________________
Parent/Guardian Name: _________________________________________
Apt. # ________________ Zip Code: ________________
Home Phone Number: _________________________________________
Work Number: __________________ Cell Phone: _________________________
Emergency Phone Number: _______________________________________________
Emergency Contact Name: ________________________________________________
Relationship: (i.e. grandparent, uncle, friend, etc.) _____________________________
Indicate if emergency contact can pick up student: _____ Yes _____ No
Parent Email Address: ___________________________________________
Would you prefer letters and documents sent via: ____ Postal Service _____ Email
_____ I do not have access to the on-line version of the handbook. I request a hardcopy.
Parent/Guardian Signature: _____________________________ Date: _____________
Student Signature: ___________________________________ Date: _____________
To be filled out by office only with copy kept on file.
_____________________________ Date hardcopy provided to parent/guardian.