20082009 Student Directory Order Form

1
Please complete all applicable areas and return
to the PTSO in the envelope provided.

• Gold Rush 2008 Capital Campaign
• Donations of 125 or more may be made In Honor
  of / In Memory of someone and will be noted in
  the newsletter.
• Name of honoree__________________________________
  _________________________________
• Name of Donor Phone ________________________
  ___________________________________________
• You may publish my name in the newsletter.
• I prefer that my donation remain anonymous and
  not be published in the newsletter.
• I am enclosing my companys matching gifts form.
  Some participating companies include B of A,
• Wachovia, Duke Energy, Piedmont Natural Gas, and
  IBM. Check with yours its an easy way to
  double
• your contribution!
• Student Name__________________________ Tax
  deductible contribution ___________

Join the PTSO! Individual memberships are
5/person. All family members are encouraged to
join! Senior students who are interested in
applying for one of the five 1000 PTSO
Scholarships given away in the spring must join
the PTSO by 01/31/2009. Student
Name__________________________________ Homeroom
Teacher_________________ Grade_____ Home
Phone ____________________ List those joining
PTSO here 1.__________________________
___________ 3.__________________________________
____ 2.________________________________
_____ 4.______________________________________
_____PTSO
Memberships X 5.00 (cost per individual) _____
2008-2009 Student Directory Order Form This
directory also contains voice mail extensions of
staff and teachers. Students official first and
last names, address phone will be published
unless noted otherwise. ALL STUDENTS WILL BE
INCLUDED UNLESS INDICATED OTHERWISE BELOW.
Contact us at directory_at_eprov.org or call Lee
Ann Babinski [phone] Student Name
_______________________________________________
Prefers to be called ______________________ Hom
eroom Teacher _________________________
Grade __________ Student Name
_______________________________________________
Prefers to be called ______________________ Hom
eroom Teacher _________________________
Grade __________ Parent Name Phone (not
published) ______________________________________

( ) I DO
NOT WISH MY CHILD TO BE INCLUDED IN THE DIRECTORY

Cost of each directory 3.00

______________x 3.00 _________
directories
ordered
Total Amount Enclosed _____________ Make
checks payable to PHS PTSO, Inc.
Mail to PHS PTSO, PMB 366, 8206 Providence Rd.
Ste. 1200 Charlotte, NC 28277