Dorseyville Middle School

Student Name(s) ** REQUIRED **

Name:  
Name Used in Classroom:  

Student’s Grade: —678

Name:  
Name Used in Classroom:  

Student’s Grade: —678

Name:  
Name Used in Classroom:  

Student’s Grade: —678

DMS Student Directory Information (select only one): ** REQUIRED **

 List the same information as last year’s DMS directory, but with the following changes listed below. This is for returning DMS students only. List standard entry for my student (student’s name, address, phone, email if provided by you, parents or guardians names, and home base). I DO NOT WANT MY STUDENT LISTED IN THE DIRECTORY (be sure to fill out student’s name). I want ONLY my student’s name and home base listed (no address, no phone, no email, no parent or guardian names). I want my student’s name, home base, address, and parent-guardian listed, but do NOT include our phone number (write UNLISTED below in the telephone number space).

Family’s Primary Email Address*:  

Student’s Female Guardian or Mother’s First and Last Name:
 

Student’s Male Guardian or Father’s First and Last Name:
 

Student’s Primary Telephone Number:
 

Student’s Primary Street Address:
 

Student’s Zip Code:  

Any other comments?

Please enter the following code into the box. This ensures you are a REAL person and helps us cut down on spam.

 

By submitting this electronically, it is the same as if you attached your signature to the form.

* Email addresses will be added to the DMS PTO mailing list, to enable your family to receive informational DMS PTO emails concerning activities and events at DMS and other district area schools. If you DO NOT want to receive emails from the DMS PTO, you may unsubscribe from the service at any time by clicking on the link provided in each email you receive, or by contacting the PTO President. Your email address will NOT be given to any other entity and will only be used for the DMS PTO mailing list.