Pto School Directory Form Washington Elementary printable pdf download

PTO School Directory Form

2014-2015

Every family at Washington Elementary School has the opportunity to be part of the PTO School Directory – regardless of PTO

membership. All families will receive one complimentary copy of the directory.

A signed directory form must be submitted for each family that appears in the PTO School Directory. Your personal information

can only be provided by you. For privacy reasons, we are unable to obtain your information from the school. Please note that

the information you provide will not be used to contact you regarding PTO events. Only families who have signed up for PTO

membership receive direct contact about PTO activities.

IMPORTANT: FOR YOUR FAMILY TO BE INCLUDED IN THE DIRECTORY THIS FORM MUST BE COMPLETED AND RETURNED TO

THE SCHOOL OFFICE OR STUDENT’S CLASSROOM NO LATER THAN FRIDAY, SEPTEMBER 12, 2014. THANK YOU!

1. DIRECTORY PRINTING OPTIONS

YES, my family would like to be included in the school directory. (Please list only the information you want

published)

NO, Please DO NOT include my family or student in the school directory. (Your family will not be listed in the

directory and your student will not appear on his or her class roster.)

2. STUDENT NAME(S)

Last Name of Student(s): ____________________________________________________________________________

First Name of Student(s):

a. __________________________________________________ Teacher/Grade ____________________________

b. __________________________________________________ Teacher/Grade ____________________________

c. __________________________________________________ Teacher/Grade ____________________________

3. PRIMARY HOUSEHOLD INFORMATION

Parent/Guardian 1 _______________________________ Parent/Guardian 2 ________________________________

Street Address __________________________________________________________________________________

City ____________________________________________________ Zip Code ______________________________

Home Phone # _________________________________ Alternate Phone # _________________________________

E-Mail Address __________________________________________________________________________________

Alternate E-Mail Address __________________________________________________________________________

Note: If your child resides in a second household and you would like that information published as well, please list it on the back of

this sheet.

4. PERSONAL MESSAGES & ADVERTISEMENTS - Write message on back of this sheet. Include your name and contact

information. Please make checks payable to the Washington PTO.

Parents and teachers

who wish to send words of encouragement to their children/students are welcome to

submit entries of 30 words or less. The cost is $3.00 per advertisement.

School-affiliated clubs or organizations

that wish to advertise their group are welcome to submit

entries of 30 words or less. The cost is $3.00 per advertisement.

5. ADDITIONAL COPIES - I would like to order ______ additional copies of the PTO School Directory at a cost of $5 each

for a total of $_________. Please make checks payable to the Washington PTO.

Parent/Guardian Signature ______________________________________________________ Date _____________________

Pto School Directory Form Washington Elementary