EmailMeForm
PPOS Change of Information
Please see below for the different options available on this form:
Email / Phone Number Changes:
If you need to update your email or phone number, please provide both your old and new contact information below.
Legal Guardian (LG):
The adult legally responsible for the student; parent or legal guardian.
(In some situation additional legals documents may be needed to add)
Learning Coach (LC):
The adult, designated by the legal guardian, to actively monitor, assist, and motivate the student on a daily basis to ensure academic progress and adherence.
Emergency Contact (EC):
A family‐designated adult who is not the student’s LC or LG. This contact will only be used for emergencies purposes.
Legal Guardian's name
*
Email
*
*
Student's Name
Student's Grade Level
Student ID
Student 1
Additional Students
Please include any additional students here, including their grade level and Student ID.
Change Email / Phone Number
Email
Phone Number
Add/Remove Legal Guardian
Add
Remove
Add/Remove Learning Coach
Add
Remove
Add/Remove Emergency Contact
Add
Remove
Legal Guardian (LG):
The adult legally responsible for the student; parent or legal guardian. Any decisions having to do with enrollment, registration and/or withdrawal will need to be done by the legal guardian only. For ANY changes the area below must be signed by the legal guardian.
LG - Adult Information
*
First
Last
LG Phone Number
*
###
-
###
-
####
LG Email
*
New LG Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Learning Coach (LC):
The adult, designated by the legal guardian, to actively monitor, assist, and motivate the student on a daily basis to ensure academic progress and adherence. The role and responsibilities of the LC varies based on the student’s grade level. If the LG chooses to select someone other than themselves as the LC, please note that LG are still ultimately responsible in ensuring adherence to school policies.
LC- Adult Information
*
First
Last
LC Phone Number
*
###
-
###
-
####
LC Email
*
New LC Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Emergency Contact (EC):
A family‐designated adult who is not the student’s LC or LG. This contact will only be
used for emergencies purposes. EC information becomes particularly important when your student is participating in live events, such as testing and field trips. They also become important when school staff cannot
get ahold of the LC, LG or student by phone or by email.
EC - Adult Information
*
First
Last
EC Phone Number
*
EC Email
*
New EC Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Previous Email
*
New Email
*
Previous Phone Number
*
###
-
###
-
####
New Phone Number
*
###
-
###
-
####
