Grandparent Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Grandchild 1

First Name

Last Name

Grandchild 2

First Name

Last Name

Grandchild 3

First Name

Last Name

I CAN (CHECK ALL THAT APPLY):

Read to a class

Make copies

Bake a good / cook a dish for a faculty lunch event

Set-up, serve, clean-up for a faculty lunch event

Water/tend to plants on front porch of school

Monitor hall duing state testing

Help with a special project

Help with a special event (registration table, set-up, etc)

Parent Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

My Child Is:

First Name

Last Name