Rosa Parks Middle School PTA

2011-2012 Student Directory

Each year, our PTA creates a student directory for the benefit of our members. We receive the student name, grade, addresses and phone number from the school, but we give you the opportunity to provide additional information, such as parent/guardian names, alternate phone numbers, emails, and additional household information for situations such as joint custody.

If you do not want your child included in the directory, please enter his/her name and then check the ‘omit’ box.

Only enter information you wish to be included in the directory. For example, if you do not want your phone number published, do not include it here. If you provide one or more email addresses, a confirmation of your entries will be sent to those addresses.

Children at this School:

	First Name	Last Name	Grade	Omit?
1			-- 6 7 8
2			-- 6 7 8
3			-- 6 7 8
4			-- 6 7 8
5			-- 6 7 8
6			-- 6 7 8

Households Where Children Reside:

Household 1
Parent/Guardian Names
Address
City	State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY	Zip (5 digit)
Phone	Alternate Phone
Email	Alternate Email

Household 2
Parent/Guardian Names
Address
City	State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY	Zip (5 digit)
Phone	Alternate Phone
Email	Alternate Email