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"
*
" indicates required fields
STUDENT INFORMATION
How many children attend Selwyn?
*
1
2
3
Student #1 Given Name
*
First
Last
Student #1 "Goes By" Name
If different than Given Name.
Student #1 Teacher
*
K - Ashley
K - Derrick
K - Majithia
K - Maronich
K - Nelson
K - Peterson
1st - Kopp
1st - Pitts
1st - Thayer
1st - Valois
1st - Vruwink
1st - Watson
2nd - Blau
2nd - Cooney
2nd - McDonald
2nd - Mills
2nd - Patton
2nd - Thompson
3rd - Bains
3rd - Kepley
3rd - Mateer
3rd - Muth
3rd - Quattropani
4th - Cardell
4th - Lockwood
4th - Postal
4th - Vernon
5th - Chalfant
5th - Desmond
5th - Mayer
5th - Richardson
Ext (K-2 Dev) - Bayne
Ext - Clark
Ext - Davis
Ext - Eley
Student #1 T-shirt Size
*
The PTA will provide all students with a Selwyn T-shirt to be worn on field trips and at events throughout the year. Please give your student’s current size:
YS
YM
YL
YXL
AS
AM
AL
AXL
Student #2 Given Name
*
First
Last
Student #2 "Goes By" Name
If different than Given Name.
Student #2 Teacher
*
K - Ashley
K - Derrick
K - Majithia
K - Maronich
K - Nelson
K - Peterson
1st - Kopp
1st - Pitts
1st - Thayer
1st - Valois
1st - Vruwink
1st - Watson
2nd - Blau
2nd - Cooney
2nd - McDonald
2nd - Mills
2nd - Patton
2nd - Thompson
3rd - Bains
3rd - Kepley
3rd - Mateer
3rd - Muth
3rd - Quattropani
4th - Cardell
4th - Lockwood
4th - Postal
4th - Vernon
5th - Chalfant
5th - Desmond
5th - Mayer
5th - Richardson
Ext (K-2 Dev) - Bayne
Ext - Clark
Ext - Davis
Ext - Eley
Student #2 T-shirt Size
*
The PTA will provide all students with a Selwyn T-shirt to be worn on field trips and at events throughout the year. Please give your student’s current size:
YS
YM
YL
YXL
AS
AM
AL
AXL
Student #3 Given Name
*
First
Last
Student #3 "Goes By" Name
If different than Given Name.
Student #3 Teacher
*
K - Ashley
K - Derrick
K - Majithia
K - Maronich
K - Nelson
K - Peterson
1st - Kopp
1st - Pitts
1st - Thayer
1st - Valois
1st - Vruwink
1st - Watson
2nd - Blau
2nd - Cooney
2nd - McDonald
2nd - Mills
2nd - Patton
2nd - Thompson
3rd - Bains
3rd - Kepley
3rd - Mateer
3rd - Muth
3rd - Quattropani
4th - Cardell
4th - Lockwood
4th - Postal
4th - Vernon
5th - Chalfant
5th - Desmond
5th - Mayer
5th - Richardson
Ext (K-2 Dev) - Bayne
Ext - Clark
Ext - Davis
Ext - Eley
Student #3 T-shirt Size
*
The PTA will provide all students with a Selwyn T-shirt to be worn on field trips and at events throughout the year. Please give your student’s current size:
YS
YM
YL
YXL
AS
AM
AL
AXL
PARENT/GUARDIAN COMMUNICATION INFORMATION
Please provide the email address you would like to use to receive information from the PTA, including information related to your child’s classroom and/or grade level.
Parent/Guardian Name(s)
*
First
Last
Address (Please include street types: Dr, Ln, St, Rd, Cir, Pl, Ave)
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Parent/Guardian Email
*
Phone
*
(Please use this format XXX-XXX-XXXX)
Additional Parent/Guardian Name
First
Last
Additional Parent/Guardian Email
Additional Phone
(Please use this format XXX-XXX-XXXX)
Additional Address (Please include street types: Dr, Ln, St, Rd, Cir, Pl, Ave)
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
SELWYN DIRECTORY OPT IN/OPT OUT
Please note that each year we publish a School Directory for members of our community. Your contact information will be included in our School Community’s Directory and you will be signed up to receive our weekly newsletter (and best source for everything Selwyn), the Eagle Email.
Opt Out of Printed Directory/Email Communication (optional)
I do NOT wish to receive the weekly Eagle Email, with school information and events.
I do NOT want my email address published in the Selwyn School Directory.
I do NOT want my phone number published in the Selwyn School Directory.
I do NOT want my home address published in the Selwyn School Directory.
How many additional directories do you want to order? First copy is free to each family. Each additional copy is $5/each.
The first copy of the Selwyn School Directory is free to each family. Additional copies are $5/each
0
1
2
3
ALL STUDENTS - CHILDREN'S THEATRE
The Children's Theatre ticket price is $18/student.
SCHOLARSHIP
Children's Theater Scholarship
Sponsor an additional Children’s Theater ticket for a child who needs it. $18/student (optional)
Please Select
1 student - $18
2 students - $36
3 students - $54
5TH GRADE ONLY
Celebrate your graduating 5th grader and spread some Selwyn pride throughout your neighborhood! Order "Where Eagles Fly" yard sign for $10 each.
How many signs would you like to order?
0
1 sign - $10
2 signs - $20
3 signs - $30
5th Grade Activity Fee
I will pay at a later time
1 student - $50
2 students - $100
3 students - $150
PTA MEMBERSHIP
Joining the PTA on an annual basis gives you membership in local, state and national organizations that invest in the future of all children and promote partnerships between schools and parents. Membership dues are $10 per person / $20 per couple.
2024-2025 Selwyn PTA Membership
Select One
Membership - 1 person ($10)
Membership - Couple ($20)
No Membership
SUMMARY
Children's Theatre - 1 Student
Price:
Children's Theatre - 2 Students
Price:
Children's Theatre - 3 Students
Price:
Children's Theatre Scholarship - 1 Student
Price:
Children's Theatre Scholarship - 2 Students
Price:
Children's Theatre Scholarship - 3 Students
Price:
2024-25 PTA Membership - Couple
Price:
2024-25 PTA Membership - 1 Person
Price:
Additional Directories (Qty 1)
Price:
Additional Directories (Qty 2)
Price:
Additional Directories (Qty 3)
Price:
5th Grade Sign (Qty 1)
Price:
5th Grade Sign (Qty 2)
Price:
5th Grade Sign (Qty 3)
Price:
5th Grade Activity Fee (1 student)
Price:
5th Grade Activity Fee (2 students)
Price:
5th Grade Activity Fee (3 students)
Price:
5th Grade Activity Fee Scholarship [optional]
Donate any amount to help cover the activity fee for a student in need.
Total
PAYMENT OPTIONS
How do you want to pay?
*Payment must be made online or returned to your child's teacher by
Wednesday, September 4
.
Pay with paypal (will be directed to paypal after submitting form)
Print receipt and send into school with check
To prevent spam, solve this simple math problem below.
PTA Info
Enroll at Selwyn
Tours and Events
Current Parents
Fundraising
School Store
PTA Info
Enroll at Selwyn
Tours and Events
Current Parents
Fundraising
School Store