School Directory Permission

State law requires that Ruffing have a signed statement giving permission to include your child’s name, address and telephone number in our directory. We have found it helpful to also include email addresses and cell phones. Please fill out the following form and if you would like to omit information, simply leave that line blank.

By completing the information below, I give my permission for Ruffing Montessori School to include the following information in our school directory for the duration of my child’s enrollment at Ruffing.

I understand that this directory will only be given to parents of children enrolled at Ruffing Montessori School, solely for school related purposes.

School Directory Permission Form *Only primary and new students

Information as it will appear in directory:

Child's First Name *

Child's Last Name *

Street Address

Street Address- Line 2

City

State

Zip

Home Phone

Parent/Guardian 1:

Title

Mr.

Mrs.

Dr.

Ms.

Name *

Cell Phone

Email

Parent/Guardian 2:

Title

Mr.

Mrs.

Dr.

Ms.

Name *

Cell Phone

Email

Signature:

Clear

Date *

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