JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Say No To Drugs Club - 5th Grade Students ONLY
Details about the program - Click on the link for information about the Say No to Drugs Club
https://docs.google.com/document/d/1xjEJB_7ATNauJPnuTI5ieERAu_XxwGRS/edit
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Last Name
*
Your answer
Student First Name
*
Your answer
Homeroom Teacher
*
Funchess
Padilla
Smith
Walsh
I understand that the club meetings are held after school. Bus transportation is
not
provided. My child will be transported from the Say No to Drugs Club by (please specify):
car
walk
I grant permission for my son/daughter to participate in the Manning Elementary Say No to Drugs Club. I give permission for my child to be photographed and/or filmed for our school yearbook, newspaper, hall display, newsletter, website and blog.
yes
no
Best phone # for Mrs. Dispensa to contact if needed
*
Your answer
Best email for Mrs. Dispensa
to contact if needed
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Community Unit School District 201.
Report Abuse
Forms