Piedmont High School Student Information
Please complete the following information about your student. Any field with an (*) asterisk must be completed. If you have more than one student enrolled in Piedmont High School, please submit this form for EACH student.
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Student Last Name *
Student First Name *
Student Middle Initial
Student Powerschool ID Number *
Student Birth Date *
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Student Grade Level *
Student Gender
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Student Home Address *
Student City *
Student Zip Code *
Is your Mailing Address different from your permanent address? *
If your mailing address is different, please type your mailing address below. 
Phone Number you would like to receive automated messages from school - **This number will be used for Connect Ed, the mass calling program for UCPS.  *
If student lives with someone other than parent(s), who has legal custody? Please provide name and relationship
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