* Required

Student/Basic Information

Please complete all information requested on this form.

Primary Contact - Parent/Guardian Information

Person(s) with whom the student lives and has primary custody; Additional Parent/Guardian information is listed separately.

(with whom the student lives)​​​​​​​
(with whom the student lives)​​​​​​​​

Non-Custodial Parent Information

Person(s) with whom the student DOES NOT live.

Should this person receive a separate mailing?​​​​​​

Notify Information

School Reach is the automated telephone calling service that is used to notify the Mount community of special announcements such as school closings or other important and timely information. Communication will be sent via email, voice, and text. Provide home and cell phone numbers as well as email address to receive alert notifications.

Primary Email address – one which is checked on a REGULAR BASIS.​​​​
Primary phone number – one which can receive text messages​ and phone calls/voice messages.​​​​

Additional Contact Information to receive notifications (may include student cell to receive text alerts from school):

Emergency Contact Information

List contacts other than parents.

Code Red Information

In case of an emergency on school property.

If student drives to school, would you allow her to drive herself directly home in the case of a Code Red emergency?​
If a non-driver, would you grant her permission to be driven home by another MSDA community member?​​​​​​
Would you prefer that your daughter remain in school until you or a person designated by you arrives? (Answer this question only if a non driver.)​​​​

Sibling Information

If multiple siblings, provide additional information.

Alumnae Affiliation

If multiple alumnae, provide additional information:

Electronic Signature

Type Parent Name

Please provide an email address where we can send a link to your current form.

Email Address :