ST. MARTIN BUZZ BOOK PERMISSION FORM

We need permission to publish the students' names, addresses and phone numbers in the book.  Please fill out the information below.  Please fill out a separate form for each child so no one is missed.  If you do not want your child's address and phone number to be published, please indicate this on the form and the child's name will be the only information put in the book.

The Buzz Book sells for $3.00.  Send your money in with the form if you wish to purchase a book.

Buzz Book Forms need to be returned by August 20, 2010

Student Name _____________________________________________          

Phone # __________________________________________________

Email Address _____________________________________________

Parents Name ______________________________________________

Address ___________________________________________________

Parent(s) Signature __________________________________________