DIRECTORY PERMISSION SLIP

The Midland PTO is going to put together a school directory for the 2008-2009 school year.  If you are interested, please fill out the form below.  Your information will be placed in the directory ONLY if the form is returned.  Thank you for your continued support.

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I ________________________________________give my permission to use my name, address, phone number and child/children’s name(s) in the school directory.

I ________________________________________DO NOT give permission to be placed in the school directory.

(Please print)

NAME: ______________________________________________________________________

STUDENT’S NAME:__________________________________GRADE:________________

                                                                                                     TEACHER:________________

STUDENT’S NAME:__________________________________GRADE:________________

                                                                                                     TEACHER:________________

STUDENT’S NAME:__________________________________GRADE:________________

                                                                                                     TEACHER:________________

STUDENT’S NAME:__________________________________GRADE:________________

                                                                                                     TEACHER:________________

STUDENT’S NAME:__________________________________GRADE:________________

                                                                                                     TEACHER:________________

STUDENT’S NAME:__________________________________GRADE:________________

                                                                                                     TEACHER:________________

ADDRESS: __________________________________________________________________

PHONE NUMBER:___________________________________________________________

EMAIL ADDRESS: ___________________________________________________________

PLEASE RETURN THIS FORM TO SCHOOL NO LATER THAN FRIDAY, SEPTEMBER 12^th.  Please contact an officer of the Midland PTO if you have any questions.  Thank you.