St. Thomas More School - Emergency Contact/Verification Form

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Emergency Contact/Verification Form
Please fill out the following forms and return them to vpage@stmct.org. Thank you.
Student Information
First Name *
Middle Name
Last Name *
Home Address *
City *
State *
Country *
Zip/Postal Code *
Home Phone *
Cell Phone
E-mail Address
Student Lives With
Parent Information
Father's Name *
Home Phone *
Home Fax
Cell Phone
Work Phone
Work Fax
E-mail Address
Mother's Name *
Home Phone *
Home Fax
Cell Phone
Work Phone
Work Fax
E-mail Address
Guardian Information
Stepmother or Guardian *
Home Phone *
Home Fax
Cell Phone
Work Phone
Work Fax
E-mail Address
Stepfather or Guardian *
Home Phone *
Home Fax
Cell Phone
Work Phone
Work Fax
E-mail Address
Emergency Contact
Name *
Phone *
Relationship to Student *
Name *
Phone *
Relationship to Student *