Willow Creek Middle School

Rochester Public Schools • Independent School District #535

OFFICE > Communications

Willow Creek Communication Form 2011-2012

Welcome to the Willow Creek Communications Form!
This form is used to gather contact information for Willow Creek volunteers, directory, and PTSA. Filling out this form is one of the best ways to be included on the distribution lists used by all of these groups. Thank you for taking the time to fill this out!

If you are a family with parents at different addresses, please fill out the form separately for each parent.
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Please fill out this form by August 25, 2011 for the 2011-2012 school year. After this date, it will take 2-4 weeks for information to be updated. Thanks!

Please indicate the first and last name of the person filling out the form.

*First Name:

*Last Name:

Parent/Guardian Name(s)--Provide last name only if different from student (Joe/Sue):

Last Name:

Primary Phone (000-000-0000):

Email:

Email 2:

Address:

City:

Zip Code:

Student #1

Student First Name:

Student Last Name:

Grade:

Student #2

Student First Name:

Student Last Name:

Grade:

Willow Creek Online Student Directory

Please include the information provided above in the Willow Creek Student Directory (online and/or hard copy).

	Yes
	No

Directory information will include Student's Name, Parents' Names, Address, Home Phone, Email Address, and Grade. If you choose yes, this information will be published. Please use the Comments section if you need to identify a specific item that you do not want published.

Volunteer Opportunities

I am interested in receiving e-mails regarding volunteer opportunities at Willow Creek Middle School.

	Yes
	No
	I am interested but I have no email, please contact me by phone.

PTSA Communication

Sign me up for the Willow Creek PTSA School Notification System. Those who sign up will receive Willow Creek-related parent-driven messages. These may include reminders about PTSA events or other information pertinent to Willow Creek families. These e-mails will come from a Willow Creek PTSA Board member and the e-mail list will be protected for this use only. You may ask to be removed from this list at any time.

Please do NOT sign me up for the Willow Creek PTSA School Notification System.

PTSA Membership

	Individual Membership-$10
	I do not wish to be a member of the PTSA
	Additional Tax-Deductible Donation for Willow Creek Student Activities

Donation Amount:

If you chose membership, please provide member name here. Last name:

First Name:

Comments:

Please review the information you have typed. Hitting the send button is equal to a signature...you are giving the WC PTSA permission to publish your information in the WC Student Directory (online &/or hard copy). The online format will be password protected for access by Willow Creek families and staff only.

* Indicates Required fields.