Connect-Ed Message Delivery

This form will sign you up for Connect-Ed, which will automatically call your phone 
numbers with important information such as school closings or delays.

Student Name:  
First Name:Last Name:
Street Address: 
Zip Code:Home Phone Number:


If there are parents/guardians living in seperate locations, please enter one 
additional phone number and contact that will receive ALL calls.

Contact Name:Phone Number:


Please enter in any other alternate numbers contacts below.

Cell Phone:Contact Name:
Work Phone:Contact Name:
Alternate Home Phone:Contact Name:
Alternate Cell Phone:Contact Name:
Alternate Work Phone:Contact Name:


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