Spring Senior Night Memory Book
If you would like to celebrate your Senior in the PHS Spring Senior Night Memory Book, please complete the following form. Payment for ads are due by Friday, January 31st. Payments are cash or check made out to PHS EAST and given to Mrs. Flemmons in room 138. All ad purchases include 1 free memory book given out at school to your Senior on the day of senior night. Senior night for basketball is Tuesday, February 2nd. Send all pictures to pottsvilleeast@gmail.com right after you complete the form please!
*THIS IS NOT FOR YEARBOOK
Sign in to Google to save your progress. Learn more
Email *
Parent/Guardian Name *
Name of Senior Student *
Activity/Sport you are involved in
*
Required
Select the size ad you want: Checks made payable to PHS EAST. Cash is also accepted. *
Message you want to include on your page *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Pottsville School District.

Does this form look suspicious? Report