2011-2012 Bengal Belle Directory Information

Dear Parents (Old and New Belles and Managers),
Please take a moment to complete this form and have your daughter return
it to Miss Joerns or Madison Farrell by May 3rd . Please complete all the
information please print as neatly as possible. This information will be
used to compile the Bengal Belle Directory which will be handed out at the
August Potluck dinner.

Bengal Belle or Manager Information:
Name________________________________________________________
First
Last
Grade (Fall 2011) _______________ Birthday___________________
Home Phone___________________ Cell Phone_________________
Email address_____________________________________________
Parent Information:
Mother’s Name_________________________________________________
First
Last
Address (include zip) ___________________________________________
Home Phone___________________ Cell Phone_________________
Email address______________________________________________
Father’s Name_________________________________________________
First
Last
Address (include zip) ___________________________________________
Home Phone____________________ Cell Phone_________________
Email address_________________________________________________

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