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 for Red Ribbon Reading as well as field trips.

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 for Red Ribbon Reading as well as field trips.

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 for Red Ribbon Reading as well as field trips.

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. NOTE: You must sign up for text option EVERY year.

Parent/Guardian Name

First Last

Parent/Guardian Email

Mobile Phone

(Please use this format XXX-XXX-XXXX)

Additional Parent/Guardian Name

First Last

Additional Parent/Guardian Email

Additional Mobile Phone

(Please use this format XXX-XXX-XXXX)

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. Parents will be chosen by lottery the week of September 3rd and a mandatory Room Parent training on September 11th for selected volunteers.

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 Laura Patton at 704-804-2744 if you would like a membership card.

2019-2020 Selwyn PTA Membership

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.

Parent Name(s) for Directory

First Last

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

Street Address City State ZIP Code

Email Address

Phone

(Please use this format XXX-XXX-XXXX)

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

Additional Parent Name(s) for Directory

First Last

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

Street Address City State ZIP Code

Email Address

Phone

(Please use this format XXX-XXX-XXXX)

How many additional directories do you want to order?

First copy is free to each family. Each additional copy is $3/each.

CHILDREN'S THEATRE

Every grade attends a Children's Theatre Production at ImaginOn. For the schedule, visit the calendar on our website. WE HAVE TO PAY CHILDREN'S THEATRE IN ADVANCE SO PAYMENT IS REQUIRED NOW. Tickets are $10 per student.

Please select number of students.*

YEARBOOK

Selwyn yearbooks are available to every student. They will also be available for sale in the Spring. Purchase yours now and mark it off your list!

How many total yearbooks do you want to order?

Note: this is the total number that includes your personal orders and scholarship donation (see below)

Scholarship (optional)

Scholarship yearbooks are distributed to students in need and gifted to teachers and staff. Please indicate the number of yearbooks ordered above that are scholarship.

4TH GRADE ONLY

4th Grade Recorder - Student #1

Please select what color recorder your student would like. Recorders are $5 each.

4th Grade Recorder - Student #2

Please select what color recorder your student would like. Recorders are $5 each.

4th Grade Recorder - Student #3

Please select what color recorder your student would like. Recorders are $5 each.

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?

5th Grade Activity Fee ($30 per student): This pays for the Whitewater Center field trip and other special events throughout the year.

Please select number of 5th Grade students.

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

SUMMARY

2018-2019 PTA Membership - Couple

Price: $14.00

2018-2019 PTA Membership - 1 Person

Price: $7.00

Additional Directories (Qty 1)

Price: $3.00

Additional Directories (Qty 2)

Price: $6.00

Additional Directories (Qty 3)

Price: $9.00

Yearbook (Qty 1)

Price: $15.00

Yearbooks (Qty 2)

Price: $30.00

Yearbooks (Qty 3)

Price: $45.00

Children's Theatre Tickets (1 student)

Price: $10.00

Children's Theatre Tickets (2 students)

Price: $20.00

Children's Theatre Tickets (3 students)

Price: $30.00

4th Grade Recorder - Student #1

Price: $5.00

4th Grade Recorder - Student #2

Price: $5.00

4th Grade Recorder - Student #3

Price: $5.00

5th Grade Sign - 1 sign

Price: $15.00

5th Grade Sign - 2 signs

Price: $30.00

5th Grade Sign - 3 signs

Price: $45.00

5th Grade Activity Fee

Price: $0.00

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 5.

To prevent spam, solve this simple math problem below.

STUDENT INFORMATION

PARENT/GUARDIAN COMMUNICATION INFORMATION

ROOM PARENT

PTA MEMBERSHIP

DIRECTORY

CHILDREN'S THEATRE

YEARBOOK

4TH GRADE ONLY

5TH GRADE ONLY

SUMMARY

PAYMENT OPTIONS

Section Break

Quick Links

K - Abbate
K - Boughman
K - Demmitt
K - Headd
K - Kellam
K - Kivuti
K - Mateer
1st - Black
1st - Goodson
1st - Roberts
1st - Shockley
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Biggs
2nd - Council
2nd - Draper-Hager
2nd - McDonald
2nd - Patton
2nd - Thayer
3rd - Brownlow
3rd - Chalfant
3rd - Dillard
3rd - Fisher
3rd - Muth
3rd - Smyth
4th - Gardepe
4th - Lockwood
4th - Maloney
4th - Mills
5th - Gordon
5th - Kuhn
5th - Kuykendall
5th - Lin
5th - Richardson
5th - Thomas
A-team - Clark
A-team - Davis
A-team - Eley

K - Abbate
K - Boughman
K - Demmitt
K - Headd
K - Kellam
K - Kivuti
K - Mateer
1st - Black
1st - Goodson
1st - Roberts
1st - Shockley
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Biggs
2nd - Council
2nd - Draper-Hager
2nd - McDonald
2nd - Patton
2nd - Thayer
3rd - Brownlow
3rd - Chalfant
3rd - Dillard
3rd - Fisher
3rd - Muth
3rd - Smyth
3rd - Williams
4th - Gardepe
4th - Lockwood
4th - Maloney
4th - Mills
5th - Gordon
5th - Kuhn
5th - Kuykendall
5th - Lin
5th - Richardson
5th - Thomas
A-team - Clark
A-team - Davis
A-team - Eley

K - Abbate
K - Boughman
K - Demmitt
K - Headd
K - Kellam
K - Kivuti
K - Mateer
1st - Black
1st - Goodson
1st - Roberts
1st - Shockley
1st - Valois
1st - Vande Weghe
1st - Vruwink
2nd - Biggs
2nd - Council
2nd - Draper-Hager
2nd - Patton
2nd - Thayer
3rd - Brownlow
3rd - Chalfant
3rd - Dillard
3rd - Fisher
3rd - Muth
3rd - Smyth
4th - Gardepe
4th - Lockwood
4th - Maloney
4th - Mills
5th - Gordon
5th - Kuhn
5th - Kuykendall
5th - Lin
5th - Richardson
5th - Thomas
A-team - Clark
A-team - Davis
A-team - Eley

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