Student Information Change Request Form
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Big Spring SD Information Change Request Form
This form can be used to submit Parent/Guardian name changes, Phone Number/Email Address changes, removing Emergency Contacts, or adding new emergency contacts.
1.
Student(s)
*
First Name
Last Name
Grade
School Building
Student Have IEP
Student 1
--Please Select--
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
--Please Select--
High School
Middle School
Mt Rock Elem
Newville Elem
Oak Flat Elem
--Please Select--
Yes
No
Student 2
--Please Select--
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
--Please Select--
High School
Middle School
Mt Rock Elem
Newville Elem
Oak Flat Elem
--Please Select--
Yes
No
Student 3
--Please Select--
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
--Please Select--
High School
Middle School
Mt Rock Elem
Newville Elem
Oak Flat Elem
--Please Select--
Yes
No
Student 4
--Please Select--
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
--Please Select--
High School
Middle School
Mt Rock Elem
Newville Elem
Oak Flat Elem
--Please Select--
Yes
No
Student 5
--Please Select--
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
--Please Select--
High School
Middle School
Mt Rock Elem
Newville Elem
Oak Flat Elem
--Please Select--
Yes
No
Student 6
--Please Select--
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
--Please Select--
High School
Middle School
Mt Rock Elem
Newville Elem
Oak Flat Elem
--Please Select--
Yes
No
Parent/Guardian Name Change
2.
Previous Name
3.
New Name
Phone Number/Email Address Change
4.
Do you wish to initiate any other changes of information?
If a field is left blank, information will not be changed. If you wish to remove current information, please enter BLANK in the field.
First Name
Last Name
Email Address
Main Number
Alternate Number
Global Connect Number
Parent/Guardian 1
Parent/Guardian 2
Emergency Contact Changes
5.
Name of Emergency Contact(s) to be removed
First name
Last Name
Contact Name
Contact Name
Contact Name
Biological parents cannot be deleted without legal documentation of restricted or terminated parental rights.
6.
Emergency Contact(s) to be added
First Name
Last Name
Phone Number
Relationship
Contact Information
Contact Information
Contact Information
7.
Are there any other changes you would like to make or other information you would like to share with us?
Are there any other changes you would like to make or other information you would like to share with us?
Yes
No
8.
Please explain:
9.
Parent Name/Signature
*
10.
Contact Phone Number if the registrar has questions
11.
Contact Email Address