RRR Pledge Form Test

PARENT INFORMATION

Parent Name

First Last

Parent Phone*

(Please use this format XXX-XXX-XXXX)

Parent Email*

How many children attend Selwyn?*

STUDENT #1 INFORMATION

Student #1 Name*

First Last

Student #1 Teacher*

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?*

How many sponsors does STUDENT #1 have?*

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*

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?*

How many sponsors does STUDENT #2 have?*

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*

What size t-shirt will your STUDENT #3 need this fall?*

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?*

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

Summary

Subtotal - Student #1 ($/HR)

Price: $0.00

Subtotal - Student #1 (Flat Donation)

Price: $0.00

Total - Student #1

Price: $0.00

Subtotal - Student #2 ($/HR)

Price: $0.00

Subtotal - Student #2 (Flat Donation)

Price: $0.00

Total - Student #2

Price: $0.00

Subtotal - Student #3 ($/HR)

Price: $0.00

Subtotal - Student #3 (Flat Donation)

Price: $0.00

Total - Student #3

Price: $0.00

Corporate Matching

Price: $0.00

To prevent spam, solve this simple math problem below.

New Student
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

New Student
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

New Student
K - Abbate
K - Demmitt
K - Derrick
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

RRR Pledge Form Test

PARENT INFORMATION

STUDENT #1 INFORMATION

STUDENT #1, SPONSOR #1

STUDENT #1, SPONSOR #2

STUDENT #1, SPONSOR #3

STUDENT #1, SPONSOR #4

STUDENT #1, SPONSOR #5

STUDENT #2 INFORMATION

STUDENT #2, SPONSOR #1

STUDENT #2, SPONSOR #2

STUDENT #2, SPONSOR #3

STUDENT #2, SPONSOR #4

STUDENT #2, SPONSOR #5

STUDENT #3 INFORMATION

STUDENT #3, SPONSOR #1

STUDENT #3, SPONSOR #2

STUDENT #3, SPONSOR #3

STUDENT #3, SPONSOR #4

STUDENT #3, SPONSOR #5

CORPORATE MATCHING

Summary

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