Chase School

Bunker Hill Elementary School
Student Information Update Sheet
ENGLISH/ALBANIA
SPANISH
PLEASE FILL IN ALL INFORMATION AND RETURN TO SCHOOL THE NEXT SCHOOL DAY.
Te hutem mbushe informate edhe ktheje ne shkolle menjehere.
FAVOR DE LLENARY ENTREGAR AL PROXIMO DIA ESCOLAR
STUDENT NAME: __________________________________________________________GRADE__________TEACHER _________________________________________
Emer e student
NOMBRE DE ESTUDIANTE
Klase/GRADO
Mesues?MAESTRA O MAESTRO
ADDRESS: __________________________________________________________________________________
Adres
DIRECCION DE HOGAR
TELEPHONE __________________________
CELL PHONE _________________________
CELL PHONE
____________________________
MOTHER’S NAME: ___________________________________________________________FATHER’S NAME:________________________________________________
Emer E Nenes
NOMBRE DE MADRE
NOMBRE DE PADRE
PLACE OF EMPLOYMENT:____________________________________________ _______PLACE OF EMPLOYMENT ________________________________________
Ku Punoni
LUGAR DE EMPLEO
Ku Punoni
LUGAR DE EMPLEO
WORK PHONE :______________________________________________EXT.__________WORK PHONE: ______________________________________EXT:________
Telephone e Punes
TELEFONO DE TRABAJO
Telepone e Punes
TELEFONO DE TRABAJO
WORK ADDRESS:____________________________________________________________WORK ADDRESS _________________________________________________
Adrese e Punes
DIRECCION DE TRABAJO
Adrese e Punes
DIRECCION DE TRABAJO
MARTIAL STATUS OF PARENTS:
MARRIED_____ SEPARATED _______ DIVORCED _________ SINGLE ________
Prindit Jane:
Matuar/Casados Indare/Separados
Indare/Divorciados
Bequar/Soltero o Soltera
CHILD LIVES WITH: BOTH PARENTS ___________MOTHER ______ FATHER __________OTHER (EXPLAIN)________________________________________
Femi rrone me:
Te Dy Prindit/AMBOS PADRES Nene/MADRE
Baba/PADRE
Tjiter/ALGUIEN MAS (explique)
NINIO VIVE CON:
EMERGENCY CONTACT: THIS SHOULD BE A PERSON WHO CAN COME FOR THE CHILD IN THE EVENT YOU CANNOT BE REACHED DURING THE
SCHOOL DAY.
REMEMBER…….YOU MUST PROVIDE TRANSPORTATION FOR ANY ILL CHILD. PLEASE INFORM US IF THERE ARE CHANGES DURING THE YEAR.
Ne rast urgience: Po te semuret femije persone qu vine dot ta maren, ne ora tedites. Duhet te kene makine ta maren.
//EN CASO DE EMERGENCIA, ESTA PERSON A DEBE PODER VENIR A LA ESCUELA A RECOGER A SU HIJO/A…….RECUERDE QUE UD. DEBE PROVEER
TRANSPORTACION PARA UN HIJO/A ENFERMA. NOTIFIQUENOS DE CUALQUIER CAMBIO.
EMERGENCY NUMBERS (LIST IN ORDER NUMBERS TO BE CALLED:
Ne rast urgience telephone numer: // LISTA DE NUMEROS DE EMERGENCIA (EN ORDEN DE SER LLAMADOS)
NAME:_____________________________________________________________PHONE___________________________RELATIONSHIP________________________
Emer///NOMBRE
Telefone///TELEFONE
Lidhje me student///RELACION
NAME: _____________________________________________________________PHONE___________________________RELATIONSHIP________________________
NAME: _____________________________________________________________PHONE___________________________RELATIONSHIP_________________________
BABYSITTER NAME: _______________________________________ADDRESS______________________________________________PHONE:____________________
I GIVE PERMISSION FOR THE ABOVE NAME PERSON(S) TO PICK UP MY CHILD IF I CANNOT BE REACHED AND MY CHILD IS NOT FEELING WELL.
Toj njeres kane leje ta marin student pot e jete semur ne shkolle.///LE DOY PERMISO A LA PERSONA INDICADA PARA RECOGER A MI HIJO/A SI NO ME ALCANZAN Y MI
HIJO/A ESTA ENFERMO/A.
PARENT/GUARDIAN SIGNATURE: ___________________________________________________________________________DATE____________________________
// FIRMA DE PADRE O ENCARGADO
/// FECHA