Back to School Form

STUDENT INFORMATION

How many children attend Selwyn?*

Student #1 Given Name*

First Last

Student #1 "Goes By" Name

If different than Given Name.

Student #1 Teacher*

Student #1 T-shirt Size*

All students will receive a t-shirt to be worn throughout the year.

Student #2 Given Name*

First Last

Student #2 "Goes By" Name

If different than Given Name.

Student #2 Teacher*

Student #2 T-shirt Size*

All students will receive a t-shirt to be worn throughout the year.

Student #3 Given Name*

First Last

Student #3 "Goes By" Name

If different than Given Name.

Student #3 Teacher*

Student #3 T-shirt Size*

All students will receive a t-shirt to be worn throughout the year.

PARENT/GUARDIAN COMMUNICATION INFORMATION

Please provide the email address you would like to use to receive information from the PTA. This includes emails sent from room parents in your child’s class as well as the grade level emails. * Please include a mobile number if you would like to receive text reminders from the PTA. NOTE: You must sign up for the text option EVERY year.

Parent/Guardian Name(s)*

First Last

Address (Please include street types: Dr, Ln, St, Rd, Cir, Pl, Ave)*

Street Address City 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 State ZIP Code

ROOM PARENT

Room Parents are responsible for recruiting and scheduling volunteers, maintaining the online class calendar, and regularly communicating with the teacher and parents. If you are interested in being a room parent for your child's class, please indicate below.

If you are interested in being a room parent for your child's class, please select the class(es) below where you are willing to serve.

[More than one class can be selected by holding the CTRL key. ]

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 $7 per person / $14 per couple. Please contact Lori Welke at 503-956-8591 if you would like a membership card.

2021-2022 Selwyn PTA Membership

5TH GRADE ONLY

Celebrate your graduating 5th grader and spread some Selwyn pride throughout your neighborhood! Order "Where Eagles Fly" yard sign for $15 each.

How many signs would you like to order?

5th Grade Activity Fee: This pays for the Whitewater Center field trip fee and other special events throughout the year.

5th Grade Activity Fee/Scholarship - If you would like to help scholarship another student, any amount is appreciated!

SUMMARY

2020-21 PTA Membership - Couple

Price:

2020-21 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:

Total

$0.00

PAYMENT OPTIONS

How do you want to pay?

*Payment must be made online or returned to your child's teacher by Wednesday, September 4.

To prevent spam, solve this simple math problem below.

STUDENT INFORMATION

PARENT/GUARDIAN COMMUNICATION INFORMATION

DIRECTORY

ROOM PARENT

PTA MEMBERSHIP

5TH GRADE ONLY

SUMMARY

PAYMENT OPTIONS

Quick Links

K - Abbate
K - Demmitt
K - Derrick
K - Fisher
K - Mateer
K - Sparks
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - Headd
2nd - McDonald
2nd - Patton
2nd - Powers
3rd - Brownlow
3rd - Chalfant
3rd - Kepley
3rd - Majithia
3rd - Muth
3rd - Smyth
4th - Ashley
4th - Lockwood
4th - Mills
4th - Postal
5th - Kuykendall
5th - Lin
5th - Richardson
5th - Watson
A-team - Clark
A-team - Davis
A-team - Eley

K - Abbate
K - Demmitt
K - Derrick
K - Fisher
K - Mateer
K - Sparks
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - Headd
2nd - McDonald
2nd - Patton
2nd - Powers
3rd - Brownlow
3rd - Chalfant
3rd - Kepley
3rd - Majithia
3rd - Muth
3rd - Smyth
4th - Ashley
4th - Lockwood
4th - Mills
4th - Postal
5th - Kuykendall
5th - Lin
5th - Richardson
5th - Watson
A-team - Clark
A-team - Davis
A-team - Eley

K - Abbate
K - Demmitt
K - Derrick
K - Fisher
K - Mateer
K - Sparks
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - Headd
2nd - McDonald
2nd - Patton
2nd - Powers
3rd - Brownlow
3rd - Chalfant
3rd - Kepley
3rd - Majithia
3rd - Muth
3rd - Smyth
4th - Ashley
4th - Lockwood
4th - Mills
4th - Postal
5th - Kuykendall
5th - Lin
5th - Richardson
5th - Watson
A-team - Clark
A-team - Davis
A-team - Eley

I am not interested in being a room parent this year
K - Abbate
K - Demmitt
K - Derrick
K - Fisher
K - Mateer
K - Sparks
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - Headd
2nd - McDonald
2nd - Patton
2nd - Powers
3rd - Brownlow
3rd - Chalfant
3rd - Kepley
3rd - Majithia
3rd - Muth
3rd - Smyth
4th - Ashley
4th - Lockwood
4th - Mills
4th - Postal
5th - Kuykendall
5th - Lin
5th - Richardson
5th - Watson
A-team - Clark
A-team - Davis
A-team - Eley