MEMORIAL SCHOOL E-MAIL ADDRESS AUTHORIZATION FORM

August 2007

 In order to save costs on printing school notices and expedite the delivery of letters and other district or school communications to parents, all Memorial School notices and other pertinent district information (with the exception of the first day of school packet) will now be sent electronically to e-mail addresses provided by parents/guardians.

Please provide your e-mail address which can be used by Memorial School personnel for the purpose of e-mailing school bulletins and other important school and district information. Your e-mail address will not be shared with anyone other than relevant school district personnel, and will remain private and confidential.

Keep in mind your employer’s e-mail rules and regulations before providing a work email address.  PLEASE DO NOT PROVIDE A STUDENT’S E-MAIL ADDRESS!!

Name(s) of Student(s) in Memorial School        Grade(s)           Homeroom Teacher(s)/Team(s)

Parent/Guardian E-Mail:__________________________________________________________

                                                (Please print clearly to distinguish between #1 and letter l and #0 and letter O)

A second e-mail address may be included below if both parents/guardians wish to receive the same information:

Second Parent/Guardian E-Mail:___________________________________________________

(Please print clearly to distinguish between #1 and letter l and #0 and letter O)

Parent/Guardians who do not have access to the Internet or e-mail should complete below.

A hardcopy of all e-mails will be provided.

Parent/Guardian Name (please print):______________________________________________

(Please sign the form below and return it with your child’s first-day packet.)

I give permission for the Medford Township School District to enter the above e-mail         address(es) into a private and secure database for the purpose of electronically sending school or district communications while attending schools in the Medford Township School District.

Signed (Parent/Guardian) ______________________________     Date____________________

Parent/Guardian Name (Print NEATLY):____________________________________________