COPPELL ISD Recognition Banquet- Top 5% Student Form
Please complete this form and submit it by Noon on Tuesday, February 19, 2019. You can contact Angie Arthur (aarthur@coppellisdef.com or 214-496-6054) if you have any questions.
First Name: *
Last Name: *
High School you attend *
Student's preferred email address: *
Student's Cell phone #: *
xxx-xxx-xxxx
Parent's Email Address: *
What are your college and/or career plans after high school (or those you anticipate at this time)? *
If you don't know your college or major at this time, list your top 3 and we can reach out to you before the program is printed.
What notable activities have you been involved with in high school? *
Please list them. Ex. debate, academic decathlon, French club president, wrestling, worked all 4 years at sonic
What elementary and middle school(s) did you attend? Please tell us what city/state if not in Coppell. *
Please list them. Ex. Denton Creek and CMS North
Attach 2-4 pictures of you to be displayed at the banquet. These pictures can include family, friends, teammates, or anything else that is important to you. *
Required
Chosen Honored Teacher Information
Please list 4 CISD teachers (K-12) who have significantly influenced your life/education and tell how they have impacted you. Each teacher MUST currently teach in CISD. Please be concise and thoughtful in your statement about each teacher. Your statement will be published in the Banquet Program. We will also use a portion of your statement to create a note card for you to speak from at the banquet. If your 3rd or 4th teacher is chosen as the one to honor, we will contact you for a written paragraph about how they have impacted your life.
1st Honored Teacher
1st Teacher Name *
1st Teacher Grade Level *
1st Teacher Subject *
1st Teacher- How they have impacted you and your education *
minimum of 250 characters
2nd Honored Teacher
2nd Teacher Name *
2nd Teacher Grade Level *
2nd Teacher Subject *
2nd Teacher- How they have impacted you and your education *
minimum of 250 characters
3rd Honored Teacher
3rd Teacher Name *
4th Honored Teacher
4th Teacher Name *
RESERVATIONS FOR DINNER
Each banquet table seats 10 guests. When your table is full, efforts will be made to seat additional guests in close proximity. Students and their Honored Teacher will receive dinner compliments of Coppell ISD Education Foundation and will be seated together.
Dinner for the student will be covered compliments of the Coppell ISD Education Foundation, but reservations are required *
Required
Additional Guests? *
Each additional guest is $60.
Total number of PAID Additional Guests
NOTE: The Student and Honored Teacher will each receive their Banquet Reservation compliments of the Education Foundation and SHOULD NOT be included in the Additional PAID Guest count listed below. In order to reserve a banquet seat, payment is due by Wednesday, April 5, 2019. Payment options listed below.
Names of additional guests attending @ $60/person
Vegetarian and Gluten Free meals will be provided, if requested. Please list the name of each banquet attendee who will need a Vegetarian or Gluten Free meal AND specify Veg or GF. *
If vegetarian or gluten free meals are not needed, write NONE
Do you give Coppell ISD Education Foundation permission to take and use photographs, video and/or quoted remarks? *
Reservation and Payments DUE by April 5, 2019
All reservations and payments DUE by April 5, 2019. You may pay by cash or check (made out to Coppell ISD Education Foundation) and mail or drop it off at the Vonita White Administration Building (200 S. Denton Tap Rd). If you have any questions, you may contact Angie Arthur at 214-496-6054 or aarthur@coppellisdef.com.
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