Appendix DP TA Registration Form Local PTA

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Appendix DP TA Registration Form Local PTA Powered By Docstoc
					                                            National PTA Reflections® Program
                                                  PTA Registration Tool
                                                “The Magic of a Moment”
Use this form for completing the online registration form to advance entries to the next round of the National PTA
Reflections program. Pass a copy of this form on with your student winners to the next level.

PTA/PTSA AND SCHOOL INFORMATION

8-Digit PTA/PTSA ID Number:                              Official PTA/PTSA Name:

PTA/PTSA Address:                                        City, State, Zip

School Name:

School Address:                                          City, State, Zip

School Principal First Name:                             School Principal Last Name:

School Email:                                            School Phone:

Total School Enrollment:                                 Grades Served by School:

PTA/PTSA Contact First Name:                             PTA/PTSA Contact Last Name:

PTA/PTSA Contact Person Title:

Phone:                                          Email:

What are the ways that you celebrate your participants and winners? How do you promote Reflections to others in
the community?




SUBMITTER CONTACT INFORMATION (If different from above)
Submitter First Name:___________________________Submitter Last Name:__________________________________
Submitter Title:____________________________________________________________________________________
Phone:________________________________________Email:______________________________________________

QUESTIONS? CONTACT:
KENTUCKY PTA
kyptapattyh@bellsouth.net
502-226-6607
                                    FOR LOCAL AND DISTRICT REFLECTIONS CHAIRS
                                                 KENTUCKY PTA
 PTA REFLECTIONS PARTICIPATION: By Division, how many students participated in each of the following arts
categories:

 Division        Arts Category Participation Counts

                 ____Dance Choreography
                 ____Film Production
                 ____Literature
  Primary
                 ____Music Composition
                 ____Photography
                 ____Visual Arts


                 ____Dance Choreography
                 ____Film Production
                 ____Literature
Intermediate
                 ____Music Composition
                 ____Photography
                 ____Visual Arts


                 ____Dance Choreography
                 ____Film Production
   Middle        ____Literature
   School        ____Music Composition
                 ____Photography
                 ____Visual Arts


                 ____Dance Choreography
                 ____Film Production
                 ____Literature
High School
                 ____Music Composition
                 ____Photography
                 ____Visual Arts


                 ____Dance Choreography
                 ____Film Production
                 ____Literature
Special Artist
                 ____Music Composition
                 ____Photography
                 ____Visual Arts




QUESTIONS? CONTACT:
KENTUCKY PTA
kyptapattyh@bellsouth.net
502-226-6607


                                    FOR LOCAL AND DISTRICT REFLECTIONS CHAIRS
                                                 KENTUCKY PTA

				
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