Hillsboro R-III Public Schools Foundation

Teacher and Staff Appreciation Form

Student’s Name:  __________________________________________________________

Parent Name:  _____________________________________Phone: _________________

Address:  ________________________________________________________________

I would like to honor:

Staff Member’s Name:  _____________________________________

Grade: _________ School:  ___________________________Donation: $15___Other:____

Message: ________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________ ________________________________________________________________________

Do you want to acknowledge you and your student’s name  on the certificate?  

_______yes    _______no

Your donation is tax deductible and you will be acknowledged as a Friend of the Foundation.

Please complete the form and mail it along with your check to:  

   

Hillsboro R-III Public Schools Foundation

20 Hawk Drive

Hillsboro, MO  63050

We will send an Appreciation Certificate to the staff member.