Printable Form

ST. MARY MANNA

PROGRAM

FAMILY FOLDER CERTIFICATE DELIVERY

DISCLAIMER 2011-2012 SCHOOL YEAR

If you wish to have the school release your Manna certificates to your child via the family folder, you must complete, date, sign and return this form to the school office ASAP. This authorization will remain in effect until the last day of the school year unless the school office receives written notice otherwise. If we do not have this form on file, you will need to pick up your certificates in the school office.

I authorize St. Mary School and its representatives to release Manna certificates to my child/children listed below via the family folder. I agree to not hold the school responsible for any certificates lost after delivery to my child.

Child _________________________________ Grade/Room________________

Child _________________________________ Grade/Room________________

Child _________________________________ Grade/Room________________

Child _________________________________ Grade/Room________________