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PTO CONTACT DIRECTORY
The information you submit in this form will be used as you enter it for the school directory and published to the Ben-Hem community.

*If you do not wish to be listed in the directory, but would like to have access, please provide your email and leave all other fields blank.

If you would prefer to submit or receive this information via hard copy or have any questions, please contact theboard@benhempto.org

For additional PTO communications and event details, please check out The Ben-Hem PTO on Facebook AND sign up for the Ben-Hem Bobcat Bulletin https://groups.google.com/forum/#!forum/bobcatbulletin

•••Note for 4TH GRADE ONLY•••
**You must complete the yearbook PHOTO RELEASE SECTION to have your child/ren’s picture/s be included in the 4th grade yearbook.
***The email address you provide in the 4th grade email section will be used for 4th grade events and reminders.
Thank you for being a part of the Ben Hem PTO Community!
ENTER THE EMAIL WHERE YOUR BEN-HEM STUDENT DIRECTORY SHOULD BE SENT
Your answer
STUDENT #1 GRADE
STUDENT #2 GRADE
STUDENT #3 GRADE
**4TH GRADE YEARBOOK PHOTO RELEASE**
The 4th Grade committee must have your approval via this form to allow your child/ren’s photo to be included in the Fourth Grade Yearbook and any other 4th Grade items. If we do not have a response, we can NOT include your child/ren’s photo.
***4TH GRADE ONLY PARENT/GUARDIAN EMAIL #1***
Please enter 1st email to receive 4th Grade Event Info.
Your answer
***4TH GRADE ONLY PARENT/GUARDIAN EMAIL #2***
Please enter 2nd email (if applicable) to receive 4th Grade Event Info.
Your answer
STUDENT #1 TEACHER LAST NAME
Your answer
STUDENT #1 FIRST NAME
Your answer
STUDENT #1 LAST NAME
Enter BLANK if you do not wish to include this information in the directory
Your answer
STUDENT #2 TEACHER LAST NAME
Your answer
STUDENT #2 FIRST NAME
Enter BLANK if you do not wish to include this information in the directory
Your answer
STUDENT #2 LAST NAME
Enter BLANK if you do not wish to include this information in the directory
Your answer
STUDENT #3 TEACHER LAST NAME
Your answer
STUDENT #3 FIRST NAME
Enter BLANK if you do not wish to include this information in the directory
Your answer
STUDENT #3 LAST NAME
Your answer
STUDENT PRIMARY MAILING ADDRESS
Your answer
PARENT/GUARDIAN NAMES
Enter names as you would like them to appear in directory or BLANK if you do not wish to include this information in the directory
Your answer
PARENT/GUARDIAN PRIMARY EMAIL
Enter 1 email address. Enter BLANK if you do not wish to include this information in the directory
Your answer
PARENT/GUARDIAN 2ND EMAIL
Enter 1 email address. Enter BLANK if you do not wish to include this information in the directory
Your answer
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