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Patricia A. DiChiaro School PTA

Directory Sign Up Form

Sign up to be included in the

2009-10 School Directory

to be published by the DiChiaro PTA

 

         Would you like to be able to contact and be contacted by other parents?

 

         Make sure you are listed in the School Directory to be published in October.

 

         There is no charge to be included.  Make sure you do not miss the deadline.  Only families included in the directory will receive a copy.

 

         Forms must be returned to school by Friday, September 26, 2009.

 

         You may include as much or as little information as you'd like.  Please be aware that any information provided on this form will be published in the directory.  If you do not wish information to be included, please do not list it on the form.

Child's First Name (required)
Child's Last Name (required)
Child's Grade (required)
Child's Teacher (required)
Parent or Parent's Names (required)
Home Address
Zip Code
Home Phone
Cell Phone Number (List area code if not 914)
Additional Cell Phone Number (List area code if not 914)
Email address
I am the legal guardian of the child listed above and give permission for the information listed above to be included in the DiChiaro School Directory to be published by the PTA. I understand that any information I provide will be printed in the Directory and that the Directory will be distributed to other DiChiaro families.