This Form will be shared with your child's school to update Powerschool

District

School

Grade

Student Last Name

Student First Name

Birth Date

GSACRD STUDENT ID#:

Please select one of the following Selection required

Home Address

Parent 2 Address

Sitter Address

Phone number only

Provide details below

Street Number

Street Name

City

Postal code

Apartment

Contact information

Contact 1

First Name

Last Name

Home Phone

Work Phone

Cell Phone

Contact 2

First Name

Last Name

Home Phone

Work Phone

Cell Phone

Effective Date

Submitted by

Last Name

First Name

Email