Buzz Book Information . . .    Please fill out this form legibly and return it by June 27th!

Name of Parents/Guardian - shown the way you'd like them to appear in the Buzz Book:

1.  
  (last name) Mother
   
  (first name) Mother
2.  
  (last name) Father
   
  (first name) Father
   
  Children's names and grades in 20078-09 school year. WILL APPEAR EXACTLY AS LISTED:
   
1.  
   
2.  
   
3.  
   
  CHECK ONE:
  Last year was perfect-no changes necessary (complete parent and student names above & return)
   
  Last year was nearly perfect - include changes as listed below.
   
  We are a new family and have completed all information requested below:
   
  Mother
   
  Mother Address
   
  Mother's Phone Mother's Cell
 
include cell number in Buzz Book?   Yes     No
   
   
  Father
   
  Father Address
   
  Father's Phone Father's Cell
 
include cell number in Buzz Book?   Yes     No
   
 
Please complete this form and mail it by June 27th to:
Karen Berns
922 Marion Avenue Highland Park, IL 60035