Spackenkill

2013-2014 School Directory

Dear Parent/Guardian: The Spackenkill Elementary PTA provides a student directory for each family in our school. The sole purpose of this directory is to assist in the formation and maintenance of friendships among students. This directory is for school-related use only and shall not be made available by anyone for commercial use or charitable solicitation. The form below is a permission slip to have your child included in this directory. We are only permitted to list students whose parents have given written permission. You may choose to have your child unlisted, partially listed (such as name and grade only), or fully listed. Please sign the form below and return this form to school with your child or drop it by the Main Office by Friday, September 20th. If you have any comments or questions, please contact: Ana Lopez-Brown alobrown@verizon.net Cell: 914-755-9579 Below is the information that we have on file to be printed in the directory. Please make any necessary changes. CURRENT INFORMATION Grade: Address: Phone: Email: Parents Name: / Teacher: Students Name:

Please check here if you DO NOT WANT your child listed in the directory. Your email address will automatically be included in the PTA email distribution and blog list for PTA
announcements, minutes and other school information. If you wish to opt out of the distribution & blog list please check the box below. DO NOT include the email address in the PTA distribution and blog list.

Parent Signature:_______________________________________________

Date: ______________

Your signature is required in order to have your childs name and/or info be printed in the directory.