Parent/Student Contact Information

Please print all information except where your signature is needed at the bottom of page 16.  This form is TWO pages long and BOTH pages are due by August 22, 2008.

Student Name_____________________________________Grade___________

Class________________________Instrument___________________________

                        Father                                                                        Mother

____________________________Name_______________________________

____________________________Address______________________________

___________________________Home Phone__________________________

___________________________Cell Phone___________________________

___________________________Work Phone__________________________

*We would like to have parent/guardian email addresses, so that we may communicate regarding your student’s band involvement and possibly send a monthly newsletter.  WE WILL NOT SEND FORWARDED MAIL, CHAIN LETTERS, ETC.  Please list your email address that is most often checked, and changes the least.

Email(s)________________________________________________________

VOLUNTEERS

If you are willing to help out the band in any way, please check what you would be capable of and interested in:

____Office Assistant                                               ____Chaperone Committee

____Newsletter Committee                                   ____Program Committee

____Hospitality/Awards Committee                     ____Fundraising Committee

____Other (Please specify) ________________________________________________________________________________________________________________________________

Continue to page 16

Please check the statement that applies to you:

____I am presently on the approved volunteer list at Lakeland Highlands Middle School.

____I am on the approved volunteer list, but not at this school.

____I am not on the approved volunteer list.

You may submit a volunteer application for Polk County Schools online.  The form is located under “For our Parents”, “Forms” at http://www.pcsb.k12.fl.us

For the safety of our children, all volunteers in Polk County Schools are required to complete an application with references.  Applicant names will be submitted to the Florida Department of Law Enforcement for a background check and all references will be contacted.  After the background check and receipt of references, the names of applicants will be submitted to the School Board for approval.  After Board approval, volunteers may begin working.  It is estimated that this process requires one month to complete.  If you have completed a form since 1986, you do not need to fill out another.

BAND BOOSTER APPLICATION

The LHMS Band Parent Association assists the band by purchasing new music, new instruments, renting concert halls, paying Florida Bandmasters Association dues, instrument repairs, band phone, paper, supplies, bulk mailing, band activities, and awards.  The Booster program is optional, but highly encouraged. Your contribution helps keep the LHMS Band #1!

Members of the Booster program receive special recognition:

____Bronze Booster $15.00:  Program recognition

____Silver Booster $30.00:  Two winter and spring concert tickets and program recognition

____Gold Booster $50.00:  Three winter and spring concert tickets and program recognition

____Cougar Booster $75.00:  Four winter and spring concert tickets and program recognition. 

Please indicate how you would like your name printed in the program:

_______________________________________________________________

Please make checks payable to LHMS Band and hand in with this form.

I have read, understand, and agree to comply with the policies and procedures explained in the Cougar Band Handbook.

Parent Signature__________________________________________Date__________

Student Signature_________________________________________Date__________