ICS-West Student Data Sheet
Please read and check all information carefully for accuracy before submitting. Your responses will be used to create your child's profile in our student database. Any contact listed on this form will have permission to pick up your child from school. You must list at least 2 contacts and may list up to 5.
  • Please type full name exactly as it appears on child's birth certificate.
  • / /
  • This information is required for the School District
    of Philadelphia's database.
  • This information is required for the School District
    of Philadelphia's database.
  • Must be a primary parent/legal guardian and live with student at the student's primary address.
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    This phone number will be eligible to receive school text messages and will receive periodic automated calls from the school with news and information, including emergency phone calls.
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    This phone number will be eligible to receive school text messages and will receive automated calls from the school in emergencies only.
  • - - Ext.
  • This contact should be student's 2nd parent/guardian if applicable. Otherwise, this can be student's first emergency contact.
  • Leave blank if same as student.
  • Leave blank if same as student.
  • Leave blank if same as student.
  • Leave blank if same as student.
  • Leave blank if same as student.
  • Leave blank if same as student.
  • - -
    This phone number will be eligible to receive school text messages and will receive automated calls from the school in emergencies only.
  • - -
  • - - Ext.
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