Copley High School Smoke Signals - Copley-Fairlawn City Schools

Dear Parent(s)/Guardian(s):
Copley High School PTSA STUDENT/PARENT DIRECTORY
Don’t miss out on being included in and receiving a copy of the Copley High School PTSA’s 2010-2011
Student/Parent Directory. Last year we had over 450 students listed. It’s a great resource!
To be included in this directory and receive a copy of the finished directory, please complete, sign, and
return this form to Copley High School, 3807 Ridgewood Rd, Copley, Ohio 44321 attn: PTSA
Directory. Please return no later than September 17.
You must complete and sign this form to be included in the Directory.
One directory will be provided only for households submitting this form.
Please legibly print in ink the information as you would like it to appear in the directory.
Student Information:
__________________________________________,______________________________________, _________
Child 1 Last Name First Name Grade
__________________________________________,______________________________________, _________
Child 2 Last Name First Name Grade
__________________________________________,______________________________________, _________
Child 3 Last Name First Name Grade
Street Address: ___________________________________________City:___________________________
Zip:__________ Phone Number: __________________________
E-mail Address:_________________________________________________________
(check here ______ if you do not want your email to be included in directory, then we will only use it for a database to send information)
Participates in the following school activities: (Please circle all that apply)
Child 1: Music Athletics Academic Teams Clubs
Child 2: Music Athletics Academic Teams Clubs
Child 3: Music Athletics Academic Teams Clubs
Parent(s)/Guardian(s) Information:
Name(s) of adult(s) living at above listed address___________________________________________
_____________________________________________________________________________________________
Parent/Guardian Signature
If you have any question, please contact Kim Nickerson, 330-668-6803 or kim@econtrol.com
Your participation in this Directory indicates that you will not use this information for solicitation purposes.