Family Info Sheet
Please complete the information below for the student(s) enrolled.
 
Name
Name
Name
Name
Sudent's Primary Place of Residence
Home Telephone Number
Father's Name
Father's Cell Phone
Father's Employer
Father's Occupation
Father's Work Phone
Father's Address
City
State
Zip
Mother's Name
Mother's Cell Phone
Mother's Employer
Mother's Occupation
Mother's Work Phone
Mother's Address
City
State
Zip
Student's parents are
 Married
 Seperated, Divorced
 Widowed
 Mother/Father Remarried
 Single
Student's home address above is also the address of
 Both Parents
 Mother
 Father
 Other
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Evelyn Mack     6850 Monroe Road     Charlotte, NC 28212     Phone: 704.535.8304     Fax: 704.535.2373     evelynpmack@bellsouth.net

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