BASIS Mesa Boosters Directory Form
Hello Families,

Boosters is putting together a Student/Family Directory. If you would like to have your name in the directory please input your information on this Google Doc by FRIDAY, OCTOBER 6th.

If you would like to purchase a hard copy and email file of the directory, please pay $5 via PayPal or check or cash to the front office. You do not need to purchase the directory to be in the directory.

If you think you have filled out this information before, please take a minute to input your info on the Google Doc once again. We apologize for this inconvenience, but are trying to consolidate records and get the directory out ASAP.

Thank you for your assistance!

Email address
Parent #1 First Name
Your answer
Parent #1 Last Name
Your answer
Email
Your answer
Parent #2 First Name
Your answer
Parent #2 Last Name
Your answer
Email
Your answer
Student's Full Name #1
Your answer
Student's Grade
3
4
5
6
7
8
9
10
11
12
Student #1
Student's Full Name #2
Your answer
Student's Grade
3
4
5
6
7
8
9
10
11
12
Student #2
Student's Full Name #3
Your answer
Student's Grade
3
4
5
6
7
8
9
10
11
12
Student #3
Student's Full Name #4
Your answer
Student's Grade
3
4
5
6
7
8
9
10
11
12
Student #4
Phone number
Your answer
Directory Sign UP
The BASIS Mesa Directory will be published by October 25th, 2017.
Include our family in the directory for a $5 charge (please include a check made out to BMBC or pay through your Paypal account see information below.)
Advertise your business logo or family name in the BASIS Mesa Directory
o $50 for quarter page
o $75 for half page
o $100 for full page
*Payment must be received by Oct 6, 2017 through Paypal or check delivered to be included in the Directory.
Directory Sign Up
Yes, please include our family in the directory for no charge
No, please do not include our family in the directory
Yes, I will purchase a directory for $5 (see payment options above)
No, I will not purchase the directory
$50 for Quarter Page
$75 for Half Page
$100 for Full Page
Family Connection Directory
Use this information for the directory
Student Name
Student Grade
Parent Name
Address
Email
Include in directory
Address for Directory
Your answer
Business information for Directory
Your answer
Business Advertising On Boosters Website & Facebook
Advertising on the BASIS Mesa Boosters Website & Newsletter is an excellent way to show your support and get the attention of BASIS Mesa families!
(Space is limited! Please mark interested support level and we will contact you on a first come first serve basis.)
o 3 Month Run - $150
o 6 Month Run - $350
o Full Year - $450
Business Advertising On Boosters Website & Facebook
3 Month Run $150
6 Month Run $350
12 Month Run $450
Space is limited, first come first serve.
Payments Due
Submit
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