NAME: ________________________________________________________________________

STREET: _______________________________________________________________________

CITY/ST/ZIP ____________________________________________________________________

e-mail address: ___________________________________________________________________
 

PARENT?  yes    no

I have children in the following schools:

__Bean

__Parma

__Warner

__Middle School

__High School

__Options Center 

__Other

Occupation: ____________________________

Civic Groups/activities in which you participate
__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

 
What area(s) are of particular interest to you (check all that apply)?

__Curriculum/Instruction                                                  __Buildings and Grounds (Facilities

__Technology                                                                  __Finance

__Operations                                                                   __Community Survey