Online Registration Summary

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Pasupuleti, Karthik Tej | 65341

Modified By: Submission Date: 07/18/2022

Modified Date: Confirmation Number: # 65341
Application End Year: 2023 Application Created By: Mahesh Pasupuleti

Household Emergency Contact

Pasupuleti , Uday Kishore  Gender: M
Primary Phone
Birthdate: Household: No
Home
Phone: (858)371-1988
Contact Information
Home Phone:
Home Address Cell Phone: (858)722-4921
From Portal Work Phone:
36085  ASQUITH PL   Email:
Fremont, CA 94536
Verification Information
Household has no separate Mailing Address
Address Line 1:
Change of Residence Address Line 2:
Change of Residence starting literal: No Student
Documents Uploaded: Pasupuleti , Karthik Tej Gender: M DOB:
HomeAddress waterBill.pdf Proof of Residency School: Thornton Junior High
HomeAddress2 9160custbill06222022.pdf
Proof of Residency 2 School
Student Number: 100708
Parent/Guardian
Pasupuleti , Mahesh  Gender: M Demographics
Birthdate: 03/14/1983 Household: Yes Student Cell Number:
Enrollment Grade: 08
Contact Information Enrolled School: Thornton Junior High School
Cell: (858)371-1988
Work: Housing
Other: Have fixed, regular, adequate housing: Yes
Email: mahesh.pasupuleti@gmail.com
Secondary Relationships
Email:
Mahesh Pasupuleti - Father
Parent/Guardian Guardian: true
Mailing: true
Pasupuleti , Soujanya  Gender: F
Portal: true
Birthdate: 05/14/1982 Household: Yes Messenger: true
Secondary Household false
Contact Information
Contact Order: 1
Cell: (858)361-1385
Work: Soujanya Pasupuleti - Mother
Other: Guardian: true
Email: madhu.soujanya@gmail.com Mailing: true
Secondary Portal: true
Email: Messenger: true
Secondary Household false
Emergency Contact Contact Order: 2
Gonuguntla , Mahalakshmi  Gender: F Uday Kishore Pasupuleti - Uncle
Birthdate: Household: No Contact Order: 3
Contact Information Mahalakshmi Gonuguntla - Aunt
Home Phone: Contact Order: 4
Cell Phone: (858)733-0480
Work Phone:
Email:
Verification Information
Address Line 1:
Address Line 2:
Emergency Contact
Pasupuleti , Uday Kishore  Gender: M
Birthdate: Household: No
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Pasupuleti, Karthik Tej | 65341
Student
Pasupuleti , Karthik Tej Gender: M DOB:
School: Thornton Junior High
School
Student Number: 100708

Release Agreements
Parent/Guardian Consent for Medical Treatment: Yes
Allergic to the following:
Taking the following medications:
Health Insurance Provider:
Annual Notice of Rights Acknowledgement: Yes
Student Technology Agreement: Yes
Parent Technology Agreement: Yes
Google Apps for Education Agreement: Yes
Field Trip Agreement: Yes
News and Media: Disclose
School Yearbook: Release
District Approved 3rd Party: Disclose
District/School Publications: Release

Funding Data Collection Form

Special Circumstance: None of these apply
Receive Social Services: No
Number in Household: 4
Monthly Income Range: Decline to State

Signature: