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 e-mail(s) you would like to use to receive information from the PTA. This includes e-mails sent from room parents in your child's class as well as the grade level list emails. Please include a mobile number if you would like to receive text reminders from the PTA.

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

DIRECTORY

The Selwyn Directory is an invaluable source of contact information for classmates, school staff, and the PTA Board. The Directory will automatically include the name, grade, and teacher of all students enrolled at Selwyn. Inclusion of contact information is optional. If you would like to have your student’s contact information published in the Directory, you are required to grant permission by checking “yes” the box below and provide the following information. If you do not wish your student’s contact information to be published please select “no”.

Directory Permission*

I hereby grant permission for Selwyn Elementary School PTA to publish the provided information in the Selwyn Elementary School Directory.

Parents reside separately and both would like to be included in the directory.

How many additional directories do you want to order?

First copy is free to each family. Each additional copy is $4/each.

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 Julia Cheatwood at 704-582-9888 if you would like a membership card.

2020-2021 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. Available for pick up at Back-To-School Night.

How many signs would you like to order?

SUMMARY

2020-21 PTA Membership - Couple

Price: $14.00

2020-21 PTA Membership - 1 Person

Price: $7.00

Additional Directories (Qty 1)

Price: $4.00

Additional Directories (Qty 2)

Price: $8.00

Additional Directories (Qty 3)

Price: $12.00

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.

K - Demmitt
K - Derrick
K - Fisher
K - Mateer
K/1st - Headd
K/1st - Kellam
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - McDonald
2nd - Patton
2nd - Powers
2nd - Thomas
2nd/3rd - Council/Roberts
3rd - Brownlow
3rd - Chalfant
3rd - Kuhn
3rd - Muth
3rd - Smyth
4th - Gardepe
4th - Lockwood
4th - Mills
4th - Gordon/Postal
4th/5th - Abbatte/Dillard
5th - Kuykendall
5th - Lin
5th - Richardson
A-team - Clark
A-team - Davis
A-team - Eley

K - Demmitt
K - Derrick
K - Fisher
K - Mateer
K/1st - Headd
K/1st - Kellam
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - McDonald
2nd - Patton
2nd - Powers
2nd - Thomas
2nd/3rd - Council/Roberts
3rd - Brownlow
3rd - Chalfant
3rd - Kuhn
3rd - Muth
3rd - Smyth
4th - Gardepe
4th - Lockwood
4th - Mills
4th - Gordon/Postal
4th/5th - Abbatte/Dillard
5th - Kuykendall
5th - Lin
5th - Richardson
A-team - Clark
A-team - Davis
A-team - Eley

K - Demmitt
K - Derrick
K- Fisher
K - Mateer
K/1st - Headd
K/1st - Kellam
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - McDonald
2nd - Patton
2nd - Powers
2nd - Thomas
2nd/3rd - Council/Roberts
3rd - Brownlow
3rd - Chalfant
3rd - Kuhn
3rd - Muth
3rd - Smyth
4th - Gardepe
4th - Lockwood
4th - Mills
4th - Gordon/Postal
4th/5th - Abbatte/Dillard
5th - Kuykendall
5th - Lin
5th - Richardson
A-team - Clark
A-team - Davis
A-team - Eley

I am not interested in being a room parent this year
K - Demmitt
K - Derrick
K - Fisher
K - Mateer
K/1st - Headd
K/1st - Kellam
1st - Goodson
1st - Thayer
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Draper-Hager
2nd - McDonald
2nd - Patton
2nd - Powers
2nd - Thomas
2nd/3rd - Council/Roberts
3rd - Brownlow
3rd - Chalfant
3rd - Kuhn
3rd - Muth
3rd - Smyth
4th - Gardepe
4th - Lockwood
4th - Mills
4th - Gordon/Postal
4th/5th - Abbatte/Dillard
5th - Kuykendall
5th - Lin
5th - Richardson
A-team - Clark
A-team - Davis
A-team - Eley

STUDENT INFORMATION

PARENT/GUARDIAN COMMUNICATION INFORMATION

DIRECTORY

ROOM PARENT

PTA MEMBERSHIP

5TH GRADE ONLY

SUMMARY

PAYMENT OPTIONS

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