The Early Entrance Program (EEP) has recently become more aware of the need for emergency preparedness. In the event of an emergency, we would like to have as much information as possible so that we can ensure your child(ren)'s safety. In order to do so, we will need some information about how to contact you, your child, and an "out-of-area contact." The out-of-area contact should be someone who resides outside of California or at least far enough out of the area (at least 50 miles away, the further away the better) that he/she would not be affected if a natural disaster were to occur in our area. If we are not able to locate your child or contact you if an emergency should occur, we will contact your out-of-area contact and advise you to do the same so that we may maintain communication. Please fill out the emergency contact information below and feel free to contact our offices with any further questions and/or concerns.

Thank you.

EEP Staff

Student Name:_____________________________ Email:___________________________

     Home phone:_______________________ Student cell phone:_______________________

Mother Name:_____________________________ Email:____________________________

     Work phone:_______________________ Mother cell phone:_______________________

Father Name:_____________________________ Email:____________________________

     Work phone:_______________________ Father cell phone:_______________________

Out-of-Area Contact Name:___________________________________

     Location:______________________________________________

     Relationship to Student:___________________________________

     Home phone:___________________________ Work phone:_______________________

     Cell phone:______________________________ Email:__________________________