Student Information Permission Form

I am updating your information this week. After filling out this form you will receive an email asking you to confirm. Just click on the link provided from your e-mail and we’ll be good to go.

*Note: If you have more than one e-mail our info needs to get to (example: parent e-mail and student e-mail), then you have to fill the form out for each e-mail. (sorry I couldn’t get it to allow me more than one e-mail per form)

         FullerFlutes

           Updated

    Student Information

Student First Name:

Student Last Name:

Parent:

Primary Email:

Can I text your cell?:

Yes No

Cell Phone Number:

Home Phone Number:

Street:

City:

State:

AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA WV WI WY

ZIP Code:

We respect your email privacy

 

Thanks so much!
Rebecca

p.s. This page is on a “hidden” area of my website. I will be removing it as soon as all of my studio is finished filling out the form. It is safe to your information.