CONTACT INFORMATION & PHONE DIRECTORY PERMISSION

Please fill-out the following information COMPLETELY and submit to CVA. This information WILL NOT be sold or given, by CVA, to any group or business, and will be available to CVA school members only (as indicated below).

Parent(s) Name
Children's Name(s)
and Grade(s)
Address
City, State, Zip Code
Phone Number
Email Address


Please include ALL information above in the CVA Member Directory.
Please include SELECTED information above in the CVA Member Directory.
     Parent(s) Name   Children(s) Name & Grade  Address/City/State/Zip
     Phone Number   Email Address  
We DO NOT wish to have our information included in the CVA Member Directory.

I give my permission for the above information to be included in the CVA School Phone Directory.

Signed: Date: