NameDescriptionTypeAdditional information
ID

integer

None.

USER_ID

integer

None.

First_Name

string

None.

Last_Name

string

None.

MI

string

None.

Grade

string

None.

DOB

date

None.

HomeAddress_Address

string

None.

HomeAddress_Town

string

None.

HomeAddress_ZIP

string

None.

HomeAddress_Phone

string

None.

HomeAddress_EmailAddress

string

None.

Father_Name

string

None.

Father_WorkPhone

string

None.

Father_CellPhone

string

None.

FatherAddress_IfDiffrent_Address

string

None.

FatherAddress_IfDiffrent_Town

string

None.

FatherAddress_IfDiffrent_ZIP

string

None.

FatherAddress_IfDiffrent_Phone

string

None.

FatherAddress_IfDiffrent_EmailAddress

string

None.

Mother_Name

string

None.

Mother_WorkPhone

string

None.

Mother_CellPhone

string

None.

MotherAddress_IfDiffrent_Address

string

None.

MotherAddress_IfDiffrent_Town

string

None.

MotherAddress_IfDiffrent_ZIP

string

None.

MotherAddress_IfDiffrent_Phone

string

None.

MotherAddress_IfDiffrent_EmailAddress

string

None.

SecondMailing_Requested_FLG

integer

None.

Emergency_Contact_Name

string

None.

Emergency_Contact_Phone

string

None.

Emergency_Contact_Relationship

string

None.

Physician

string

None.

PhysicianPhone

string

None.

Medications

string

None.

Allergies

string

None.

PreferredHospital_MonomounthMedCenter_FLG

integer

None.

PreferredHospital_RevierViewMedCenter_FLG

integer

None.

Other_PreferredHospital

string

None.

ParentOrGuardianSign

string

None.

Form_Date

date

None.

StudentId

integer

None.

Pupil_Have_Health_Insurance_FLG

integer

None.

Insurance_Company_Name

string

None.

Apply_Online_NJ_Family_Care_FLG

integer

None.

Release_My_Iinfo_To_NJ_Family_Care_FLG

integer

None.

Signature

string

None.

PrintedName

string

None.

FinalDate

date

None.

DocUrl

string

None.

Form_Created_Date_Time

date

None.

Is_Deleted

integer

None.