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Red Ribbon Reading Pledge Form
"
*
" indicates required fields
PARENT INFORMATION
Parent Name
First
Last
Parent Phone
*
(Please use this format XXX-XXX-XXXX)
Parent Email
*
How many children attend Selwyn?
*
1
2
3
STUDENT #1 INFORMATION
Student #1 Name
*
First
Last
Student #1 Teacher
*
New Student
K - Ashley
K - Derrick
K - Fisher
K - Mateer
K - Sparks
1st - Goodson
1st - Thayer
1st - Valois
1st - Vruwink
1st - Watson
1st - Weedon
2nd - Cooney
2nd - McDonald
2nd - Patton
2nd - Peterson
2nd - Tauber
3rd - Brownlow
3rd - Kepley
3rd - Majithia
3rd - Muth
3rd - Quattropani
4th - Lockwood
4th - Mills
4th - Postal
4th - Taylor
5th - Chalfant
5th - Kuykendall
5th - Lin
5th - Richardson
A-team - Clark
A-team - Davis
A-team - Eley
Student #1 Summer Reading Hours Goal
Please enter the number of hours your child hopes to read this summer.
Please enter a number from
0
to
200
.
What size t-shirt will your STUDENT #1 need this fall?
*
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
How many sponsors does STUDENT #1 have?
*
1
2
3
4
5
STUDENT #1, SPONSOR #1
Student #1, Sponsor #1 Name
*
First
Last
Student #1, Sponsor #1 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #1, Sponsor #1 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #1, SPONSOR #2
Student #1, Sponsor #2 Name
*
First
Last
Student #1, Sponsor #2 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #1, Sponsor #2 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #1, SPONSOR #3
Student #1, Sponsor #3 Name
*
First
Last
Student #1, Sponsor #3 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #1, Sponsor #3 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #1, SPONSOR #4
Student #1, Sponsor #4 Name
*
First
Last
Student #1, Sponsor #4 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #1, Sponsor #4 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #1, SPONSOR #5
Student #1, Sponsor #5 Name
*
First
Last
Student #1, Sponsor #5 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #1, Sponsor #5 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #2 INFORMATION
Student #2 Name
*
First
Last
Student #2 Teacher
*
New Student
K - Ashley
K - Derrick
K - Fisher
K - Mateer
K - Sparks
1st - Goodson
1st - Thayer
1st - Valois
1st - Vruwink
1st - Watson
1st - Weedon
2nd - Cooney
2nd - McDonald
2nd - Patton
2nd - Peterson
2nd - Tauber
3rd - Brownlow
3rd - Kepley
3rd - Majithia
3rd - Muth
3rd - Quattropani
4th - Lockwood
4th - Mills
4th - Postal
4th - Taylor
5th - Chalfant
5th - Kuykendall
5th - Lin
5th - Richardson
A-team - Clark
A-team - Davis
A-team - Eley
Student #2 Summer Reading Hours Goal
Please enter the number of hours your child hopes to read this summer.
What size t-shirt will your STUDENT #2 need this fall?
*
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
How many sponsors does STUDENT #2 have?
*
Select One
1
2
3
4
5
STUDENT #2, SPONSOR #1
Student #2, Sponsor #1 Name
*
First
Last
Student #2, Sponsor #1 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #2, Sponsor #1 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #2, SPONSOR #2
Student #2, Sponsor #2 Name
*
First
Last
Student #2, Sponsor #2 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #2, Sponsor #2 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #2, SPONSOR #3
Student #2, Sponsor #3 Name
*
First
Last
Student #2, Sponsor #3 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #2, Sponsor #3 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #2, SPONSOR #4
Student #2, Sponsor #4 Name
*
First
Last
Student #2, Sponsor #4 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #2, Sponsor #4 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #2, SPONSOR #5
Student #2, Sponsor #5 Name
*
First
Last
Student #2, Sponsor #5 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #2, Sponsor #5 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #3 INFORMATION
Student #3 Name
*
First
Last
Student #3 Teacher
*
New Student
K - Ashley
K - Derrick
K - Fisher
K - Mateer
K - Sparks
1st - Goodson
1st - Thayer
1st - Valois
1st - Vruwink
1st - Watson
1st - Weedon
2nd - Cooney
2nd - McDonald
2nd - Patton
2nd - Peterson
2nd - Tauber
3rd - Brownlow
3rd - Kepley
3rd - Majithia
3rd - Muth
3rd - Quattropani
4th - Lockwood
4th - Mills
4th - Postal
4th - Taylor
5th - Chalfant
5th - Kuykendall
5th - Lin
5th - Richardson
A-team - Clark
A-team - Davis
A-team - Eley
What size t-shirt will your STUDENT #3 need this fall?
*
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Student #3 Summer Reading Hours Goal
Please enter the number of hours your child hopes to read this summer.
How many sponsors does STUDENT #3 have?
*
Select One
1
2
3
4
5
STUDENT #3, SPONSOR #1
Student #3, Sponsor #1 Name
*
First
Last
Student #3, Sponsor #1 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #3, Sponsor #1 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #3, SPONSOR #2
Student #3, Sponsor #2 Name
*
First
Last
Student #3, Sponsor #2 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #3, Sponsor #2 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #3, SPONSOR #3
Student #3, Sponsor #3 Name
*
First
Last
Student #3, Sponsor #3 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #3, Sponsor #3 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #3, SPONSOR #4
Student #3, Sponsor #4 Name
*
First
Last
Student #3, Sponsor #4 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #3, Sponsor #4 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
STUDENT #3, SPONSOR #5
Student #3, Sponsor #5 Name
*
First
Last
Student #3, Sponsor #5 - $ Pledged per Hour
Enter the amount pledged per hour. Pledges should be entered in decimal form without the dollar sign. For example, if the sponsor pledged $1.50 per hour, you would enter 1.50 below. If the sponsor will make a flat donation, skip this question and enter that information in the next field.
OR Student #3, Sponsor #5 - Flat Donation
Enter the amount pledged. Pledges should be entered as whole numbers without the dollar sign. For example, if the sponsor pledged $25.00, you would enter 25 below.
CORPORATE MATCHING
Find out if your employer will provide a corporate match.
If your employer participates in Corporate Matching, please enter the amount of that pledge below.
Enter the amount pledged.
Company Name
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PTA Info
Enroll at Selwyn
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PTA Info
Enroll at Selwyn
Tours and Events
Existing Parents
Fundraising
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