Directory Form Template



“School Name” School

“School Year” School Directory Form

Every year, the “School Name” publishes a directory of students and families for the school year. It’s a great resource for setting up carpools and contacting other “School Name” families. Please complete this form and return it to the school office as soon as possible.

Important: Only use this form if:

1. Students were not listed in the “School Year” directory OR

2. You need to make changes to last year’s listing.

1. Directory Printing Options

____________YES, I want to be listed in the school directory.

____________NO, Please do NOT include me in the school directory. (Note: We still need

your e-mail address for school and PTA communication purposes.)

Please include me in the directory but DO NOT print the following information:

Address: ________ Phone number(s): _________ Email address: ________

2. Student(s) names:

Last name of student: ____________________________________

First name of student(s):

#1:________________________Grade for “School Year”:_____ #2:________________________Grade for “School Year”:_____

#3:________________________Grade for “School Year”:_____

3. Household Information:

Household #1: Parent 1:______________________ Parent 2: ______________________

Street Address______________________________________________________________

City________________________ Zip Code______________

Primary Home Phone Number: Area Code ( ) ___________________________

Alternate Phone Number: Area Code ( ) ___________________________

Email Address:______________________ Alternate Email__________________________

Use the following section if your child also resides in a second household:

Household #2: Parent 1:______________________ Parent 2: _____________________

Street Address______________________________________________________________

City________________________ Zip Code______________

Primary Home Phone Number: Area Code ( ) ___________________________

Alternate Phone Number: Area Code ( ) ___________________________

Email Address:______________________ Alternate Email__________________________

Parent signature: _______________________________ Date: _____________________

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