Moving Up Ceremony Certificate Name Form - 2018-19
Preparations for the Blind Brook Middle School Class of 2019 Moving Up Ceremony are underway. The ceremony takes place on Tuesday, June 25th at 11:00 AM. Please note that this is a change from previous years. All graduating students receive a certificate from the Blind Brook-Rye School District which certifies their completion of the middle school program.
The information you provide below will be used to personalize your child's certificate. Please complete the required information on this form taking care to ensure the proper spelling and legibility of your child's information as you would like it to appear on the certificate. For example, if you enter a middle initial without a period, it will be printed without a period on the certificate. If you child's name includes a suffix ( Jr., III, etc.) it must be included with the last name if it is to appear on the certificate. Certificates will be printed directly from this form.

Please fill out the required information below only ONCE. All submissions must be received by December 21, 2018

Feel free to call or email Ms. Paisley at 914-937-3600 ext 3119 or lpaisley@blindbrook.org if you have any questions.

Thank you for your attention to this matter.

Please provide your child's LAST NAME as you would like it to appear on the certificate. *
Your answer
Please provide your child's MIDDLE INITIAL or MIDDLE NAME if you would like it to appear on the certificate.
This is optional
Your answer
Please provide your child's FIRST NAME as you would like it to appear on the certificate. *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Blind Brook - Rye Union Free School District. Report Abuse - Terms of Service