Student Directory Opt-In

Student Name

Teacher Name

Grade Level (required)
Kindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade

Contact Information for Directory Inclusion

Parent/Guardian Name

Your Email

Telephone Number

How would you like to receive a copy of the directory?
Please send a printed copy of the directory home with my childPlease e-mail me directions on accessing the electronic version of the directory (will be sent to the email address listed above)

Confirm below to certify that you give the Beaver Acres PTO permission to publish your information as listed above in the Student Directory.

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