Name:

Business/Organization Name:

Street Address:

Home Phone:    Work Phone:

E-Mail Address:

School Preferred:

Fisher Elementary               Freeman Elementary            Gardens Elementary

Garfield Elementary            Genoa Elementary                Golden Acres Elementary

Kruse Elementary               Matthys Elementary              McMasters Elementary

Morales Elementary            Parks Elementary                 Pomeroy Elementary

L.F. Smith Elementary         South Houston Elementary   South Shaver Elementary

Sparks Elementary              Stuchbery Elementary          Williams Elementary   

Young Elementary

Day(s) of the week preferred:

General time preference:

Comments regarding any specific schedule needs: