Chatsworth Parent Email Form

Please fill in this form to provide the Chatsworth Ave. School PTA with your email address:

*Child's Last Name*
*First Name*
*Child's Grade*	(In September 2007)
*Parent Name 1*
*Parent E-mail 1*
*Parent Name 2*
*Parent E-mail 2*

- - - - - If other children in this school - - - - -
2nd Child's Name
Grade
3rd Child's Name
Grade
4th Child's Name
Grade
Please respond
Would you like your email address published in the PTA directory?	Yes - I would like my email address published No - Do not publish my email address