Econfirm Data Form

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Directory Data Confirmation Letter for Sample Elementary School Our Econfirm service will customize this form to your specifications, including the message to families displayed here. The fields below can be renamed or removed, depending upon you school requirements. Other items can be added for membership as well as ordering information. Security: this file can be password protect for each family

To be processed, you must indicate your print options and initial below: Directory Print Options:

Initial here:

Date:

Student Information: students attending 2009-1010 school year Smith

Last Name:

Student #1:

Grade: 5

TOm

O

Gender: M

Phone: 805-555-1212

Email:

Student #2:

Grade: 5

Jerry

M E

Student #3:

Grade:

Student #4:

Grade:

Current Household Information: Parent 1 First Name:

John

Parent 2 First Name:

kate

Street:

1682 Elmsford Place

City:

Westlake Village

Gender: M

D

Gender:

Gender:

Ben@yahoo.com

Phone: 805-494-8607

Email:

Will@yahoo.com

Phone: Email: Phone: Email:

Last Name if Diff: Smith Last Name if Diff:

State: CA

Zip: 91361

Please indicate after each phone number "home" or "cell". For example: 805-555-1212 home Phone 1:

805-494-3567

Phone 2: 805-807-7707

Email:

jay@okenconsulting.com

Email 2:

Tracie@mydirectorymaker.com

Print Exclusions:

Don't print Address:

Don't Print Phone:

Phone 3: 805-390-5773

Don't Print Email:


Use the following section for second household information: Parent 1 First Name:

Myrna

Last Name if Diff:

Parent 2 First Name:

kate

Last Name if Diff: Jones

Street:

3049 Earlmar Dr.

City:

Los Angeles

Phone 1:

310-558-8194

Email:

mo4travel@aol.com

Alternate Email:

do4travel@yahoo.com

Print Exclusions:

Don't Print Address:

State: CA

Zip 90064

Phone 2: 310-558-8472

Don't Print Phone:

Phone 3: 310-558-8473

Don't Print Email:

Comments: Enter any additional information you would like to give us here:

Number of Directories:

O

M E

Membership Information: Parent 1 Mbr: Parent 2 Mbr:

Parent 1 Mbr: Parent 2 Mbr:

D


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