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Home
Calendar
News
Activities
Chess Club
Destination ImagiNation (DI)
Fun Lunch
Green Team
Language Labs
Masterpiece of the Month
Reading Games
Reflections
Walking Club
W.R.E.C.K.
Young Rembrandts
School-Sponsored Activities
Events
Spring Fundraiser
Family Science Night
Book Fairs
Family Math Night
Variety Show
Fall Fundraiser
Whittier Experiences
Whittier Fun Fair
Volunteering
Committees, Explained (Or, what am I getting myself into?)
References
New? Welcome!
Join Our PTA
PTA Facebook Page
Summer Resources
Order Whittier Wear
FAQ
About Our PTA
Financials and Minutes
Reimbursements and Deposits
Committee Chair Instructions
Fundraising Opportunities
Documents and Forms
Room Parent Volunteer/Donation Form
Whittier Directory
Directory Spot Overview
Directory Download (must be logged in to view)
Donate to Whittier PTA
Donate to the Angel Fund
Home
References
Documents and Forms
Room Parent Volunteer/Donation Form
Room Parent Volunteer/Donation Form
Room Parent Volunteer and Donation Form
If you are human, leave this field blank.
Parent/Guardian Name(s)
*
Parent/Guardian Email(s)
Parent/Guardian Phone(s)
Number of Teachers
*
1
2
3
4
How many teachers are you filling this form out for today?
Teacher #1 (click to expand/collapse)
Student(s) Name
*
Teacher's Name
*
K - Boehm
K - Czeszewski
1 - Quill
1 - Richards
2 - Sullivan
2 - Swade
3 - Jurinek
3 - Modine
4 - Carey
4 - Miller
5 - Lyons
5 - Vanacora
6 - Miller
6 - Zagorski
Halloween Party Volunteer
Party Chairperson
Game Planner
Craft Planner
Will Attend, and Bring Snack
Cannot Attend, but will Provide Supplies
No thank you!
Click all that apply. You will be notified of your role (if any) by your Room Parent) once the party date approaches.
Would you like to donate to the Teacher Birthday Gift/Teacher Appreciation/Teacher Holiday Gift Fund?
*
Yes (please enter amounts below)!
No thank you, I'll do my own thing.
Teacher Birthday Gift Amount
PTA Suggests $2-$5
Teacher Appreciation Amount
PTA Suggests $5
Teacher Holiday Gift Amount
PTA Suggests $2-$5
Total Donation
Please write a check PAYABLE TO YOUR ROOM PARENT for the total amount, put it in an envelope with their name on it, and send it through your child’s backpack to the school office, or simply hand it to them in person. Your room parent may also offer the option to pay them electronically.
Teacher #2 (click to expand/collapse)
Student(s) Name
Teacher's Name
K - Boehm
K - Czeszewski
1 - Quill
1 - Richards
2 - Sullivan
2 - Swade
3 - Jurinek
3 - Modine
4 - Carey
4 - Miller
5 - Lyons
5 - Vanacora
6 - Miller
6 - Zagorski
Halloween Party Volunteer
Party Chairperson
Game Planner
Craft Planner
Will Attend, and Bring Snack
Cannot Attend, but will Provide Supplies
No thank you!
Click all that apply. You will be notified of your role (if any) by your Room Parent) once the party date approaches.
Would you like to donate to the Teacher Birthday Gift/Teacher Appreciation/Teacher Holiday Gift Fund?
Yes (please enter amounts below)!
No thank you, I'll do my own thing.
Teacher Birthday Gift Amount
PTA Suggests $2-$5
Teacher Appreciation Amount
PTA Suggests $5
Teacher Holiday Gift Amount
PTA Suggests $2-$5
Total Donation
Please write a check PAYABLE TO YOUR ROOM PARENT for the total amount, put it in an envelope with their name on it, and send it through your child’s backpack to the school office, or simply hand it to them in person. Your room parent may also offer the option to pay them electronically.
Teacher #3 (click to expand/collapse)
Student(s) Name
Teacher's Name
K - Boehm
K - Czeszewski
1 - Quill
1 - Richards
2 - Sullivan
2 - Swade
3 - Jurinek
3 - Modine
4 - Carey
4 - Miller
5 - Lyons
5 - Vanacora
6 - Miller
6 - Zagorski
Halloween Party Volunteer
Party Chairperson
Game Planner
Craft Planner
Will Attend, and Bring Snack
Cannot Attend, but will Provide Supplies
No thank you!
Click all that apply. You will be notified of your role (if any) by your Room Parent) once the party date approaches.
Would you like to donate to the Teacher Birthday Gift/Teacher Appreciation/Teacher Holiday Gift Fund?
Yes (please enter amounts below)!
No thank you, I'll do my own thing.
Teacher Birthday Gift Amount
PTA Suggests $2-$5
Teacher Appreciation Amount
PTA Suggests $5
Teacher Holiday Gift Amount
PTA Suggests $2-$5
Total Donation
Please write a check PAYABLE TO YOUR ROOM PARENT for the total amount, put it in an envelope with their name on it, and send it through your child’s backpack to the school office, or simply hand it to them in person. Your room parent may also offer the option to pay them electronically.
Teacher #4 (click to expand/collapse)
Student(s) Name
Teacher's Name
K - Boehm
K - Czeszewski
1 - Quill
1 - Richards
2 - Sullivan
2 - Swade
3 - Jurinek
3 - Modine
4 - Carey
4 - Miller
5 - Lyons
5 - Vanacora
6 - Miller
6 - Zagorski
Halloween Party Volunteer
Party Chairperson
Game Planner
Craft Planner
Will Attend, and Bring Snack
Cannot Attend, but will Provide Supplies
No thank you!
Click all that apply. You will be notified of your role (if any) by your Room Parent) once the party date approaches.
Would you like to donate to the Teacher Birthday Gift/Teacher Appreciation/Teacher Holiday Gift Fund?
Yes (please enter amounts below)!
No thank you, I'll do my own thing.
Teacher Birthday Gift Amount
PTA Suggests $2-$5
Teacher Appreciation Amount
PTA Suggests $5
Teacher Holiday Gift Amount
PTA Suggests $2-$5
Total Donation
Please write a check PAYABLE TO YOUR ROOM PARENT for the total amount, put it in an envelope with their name on it, and send it through your child’s backpack to the school office, or simply hand it to them in person. Your room parent may also offer the option to pay them electronically.
Ms. Modine's Teacher's Aide (click to expand/collapse)
Aide's Name
Ms. Podracky (Aide for Modine (3)
Would you like to donate to the Teacher Birthday Gift/Teacher Appreciation/Teacher Holiday Gift Fund for the classroom Aide?
Yes (please enter amounts below)!
No thank you, I'll do my own thing.
Aide Birthday Gift Amount
PTA Suggests $2-$5
Aide Appreciation Amount
PTA Suggests $5
Aide Holiday Gift Amount
PTA Suggests $2-$5
Total Donation
Please write a check PAYABLE TO YOUR ROOM PARENT for the total amount, put it in an envelope with their name on it, and send it through your child’s backpack to the school office, or simply hand it to them in person. Your room parent may also offer the option to pay them electronically.
Ms. Zagorski's Teacher's Aide (click to expand/collapse)
Aide's Name
TBD (Aide for Zagorski (6))
Would you like to donate to the Teacher Birthday Gift/Teacher Appreciation/Teacher Holiday Gift Fund for the classroom Aide?
Yes (please enter amounts below)!
No thank you, I'll do my own thing.
Aide Birthday Gift Amount
PTA Suggests $2-$5
Aide Appreciation Amount
PTA Suggests $5
Aide Holiday Gift Amount
PTA Suggests $2-$5
Total Donation
Please write a check PAYABLE TO YOUR ROOM PARENT for the total amount, put it in an envelope with their name on it, and send it through your child’s backpack to the school office, or simply hand it to them in person. Your room parent may also offer the option to pay them electronically.
Additional Comments
Anything you'd like your room parent to know?
Submit
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