SHENENDEHOWA KEY CLUB

MEMBERSHIP FORM

Please fill out the form below and return it to Ms. Bracken in East Library, Mr. Dunham in the South Faculty Room in East, or email an electronic version of the form as an attachment to shenkeyclub@hotmail.com

PLEASE PRINT CLEARLY

NAME  ___________________________________________
 

HOMEROOM #    _________             TEACHER  _________________________________________
 

TELEPHONE NUMBER  ____________________________________
 

EAST OR WEST BUILDING _____________  GRADE  ___________
 

E-MAIL ADDRESS  _________________________________________

This page is maintained in accordance with Shenendehowa's web publishing guidelines by bracmary@shenet.org.   Last updated 12/13/2006