Family Registration Form

Family Registration Form

Household Contact Information
Please fill this section out entirely for our records.
Family Last Name
Parent / Guardian #1
Please enter contact information for Parent / Guardian #1
Parent / Guardian Name #1
First Last

Parent / Guardian #1 Email Address

Guardian #1 Cell Phone:
Parent / Guardian #2
Please enter contact information for Parent / Guardian #2
Parent / Guardian Name #2
First Last

Parent / Guardian #2 Email Address

Guardian #2 Cell Phone:

How many students do you have enrolled at the school?
Student #1 Information
Please enter your student(s) name(s) below.
Student #1 Name
First Last

Student #1 Grade Level:*
Student #2 Information
(Optional)
Student #2 Name
First Last

Student #2 Grade Level
Student #3 Information
(Optional)
Student #3 Name
First Last

Student #3 Grade Level
Student #4 Information
(Optional)
Student #4 Name
First Last
Student #4 Grade Level

Additional Contact Information
We would appreciate it if you could provide us with additional details on your family. Portions of this data may be used as your contact info in the Student Directory if you opt to be listed in the directory below. This is optional.
Can we include your family in our Phone book?
YES
No
Primary Address
Street Address City State / Province / Region ZIP / Postal Code Country

Do you have an alternate address you would like to provide us?
Yes
No
Alternate Address
Street Address City State / Province / Region ZIP / Postal Code Country

PTO Membership*
Smokey Road PTO Membership 2021/2022-$10.00
Total
$0.00
Do you have any additional feedback? Please feel free to comment below.

SMOKEY ROAD MIDDLE SCHOOL PTO

Thank you for joining the Smokey Road PTO! You will make a difference!

Family Registration Form

Household Contact Information
Please fill this section out entirely for our records.
Family Last Name
Parent / Guardian #1
Please enter contact information for Parent / Guardian #1
Parent / Guardian Name #1
First Last
Parent / Guardian #1 Email Address
Guardian #1 Cell Phone:
Parent / Guardian #2
Please enter contact information for Parent / Guardian #2
Parent / Guardian Name #2
First Last
Parent / Guardian #2 Email Address
Guardian #2 Cell Phone:

How many students do you have enrolled at the school?
Student #1 Information
Please enter your student(s) name(s) below.
Student #1 Name
First Last
Student #1 Grade Level:*
Student #2 Information
(Optional)
Student #2 Name
First Last
Student #2 Grade Level
Student #3 Information
(Optional)
Student #3 Name
First Last
Student #3 Grade Level
Student #4 Information
(Optional)
Student #4 Name
First Last
Student #4 Grade Level

Additional Contact Information
We would appreciate it if you could provide us with additional details on your family. Portions of this data may be used as your contact info in the Student Directory if you opt to be listed in the directory below. This is optional.
Can we include your family in our Phone book?
- YES
- No
Primary Address
Street Address City State / Province / Region ZIP / Postal Code Country
Do you have an alternate address you would like to provide us?
- Yes
- No
Alternate Address
Street Address City State / Province / Region ZIP / Postal Code Country
PTO Membership*
Smokey Road PTO Membership 2021/2022-$10.00
Total
$0.00
Do you have any additional feedback? Please feel free to comment below.

Smokey Road Middle School PTO