Ms. Greco - Student Information Sheet

Student Information Sheet

Welcome to Ms. Greco's American History Class!
You must complete this form to the best of your ability.
If any of the categories do not apply to you, then insert "N/A" in the space provided.
Please follow the examples that are given in red.

School Year Example: 2006-2007

Period

Student Information

Last Name

First Name

Grade

Course

Course Number / Section

Counselor

Birch
Calise
Karpati
Lapan

Lis
Nogaj
Reilly
Rothman

Salahuddin
Smith
Speiser
Venturelli

Homeroom

Example: C308

Last Year's History Class

World History G
World History CP
World History H

American History I G
American History I CP
American History I H
American History I AP
Other

Previous History Teachers

Mr. Arts
Mr. Bell
Mrs. Caine
Mr. Carissimo
Mr. Carline
Mrs. Czuka
Mrs. De Lorenzo

Mrs. Dennison
Mr. Fackina
Mrs. Gaccione
Ms. Greco
Mr. Harding
Mr. Henry
Ms. Lametta

Mr. Lessler
Ms. Lewis
Mr. Lopez
Mr. Lotito
Mr. O'Connor
Mr. Orlovsky
Mr. Presley

Mr. Rogers
Mrs. Smith
Mr. Van Der Hey
Mr. Vancheri
Mrs. Waibel
Mrs. Wellington

Grade In History Last Year

90-100
80-90
70-80
60-70
Below 60

Personal Information

Mother's Name

Example: Mrs. Jennifer Smith

Mother's Phone Number

Example: 973-555-9876

Mother's Job

Mother's Work or Cell Number

Example: Work - 973-555-7654 or Cell - 973-555-5432

Father's Name

Example: Mr. Marc Smith

Father's Phone Number

Example: 973-555-9876

Father's Job

Father's Work or Cell Number

Example: Work - 973-555-7654 or Cell - 973-555-5432

Street Address / Zip Code

Home Phone Number

Example: 973-555-9876

E-mail Address

Example: cgreco@cliftonschools.net

Emergency Contact / Relationship

Example: Maria Smith

Example: Sister

Emergency Contact's Phone Number

Example: 973-555-9870

Ms. Greco should know...

Textbook Information

Textbook Code / Number

Overall Condition

Textbook Damage