Newsletter May 12 2015 - Chilwell Primary School

Transcription

Newsletter May 12 2015 - Chilwell Primary School
Chilwell Primary School No. 2061
“Learning for Life”
Gavan Welsh - Principal
313a Pakington Street, Newtown, 3220.
Telephone: (03) 5221 2738 Fax: (03) 5221 8191
Office Hours: 8.30 am. to 4.30 pm.
Admin Email: chilwell.ps@edumail.vic.gov.au
Web site: www.chilwellps.vic.edu.au
School Council Email: schoolcouncil@chilwellps.vic.edu.au
Facebook: www.facebook.com/ChilwellFoodFair
Out of School Hours Child Care Program Coordinator (0417 014 973)
NEWSLETTER No.13 – 12TH MAY 2015
Apr 27-Jun 9
May 12-14
May 14-15
May 15
Fri
May 18
Mon
LSL Helen Jellett Replacement Kathy Smith
NAPLAN – Grs.3 & 5
Prin Conference. Gavan & Scott
Report Writing Child Care booking form due
Office renovations commence
Secondhand uniforms for sale – at assembly
May 18-22
Education Week
2016 Prep Enrolment Week
May 19
Tues 2016 Prep Tour 9.30-10.30
2016 Prep Parent Information Evening 7-8pm.
New Athletics Day Grs.3-6 – Landy Field
May 20
Wed Winter Lightning Premiership – Footy & Soccer
May 21
Thurs Preps Grandparents/Special Friends Day 9-11am.
2016 Prep Tour 2.30-3.30
Numeracy session 2.30-3.30
May 22
Fri
Education Week Open Session 9-11am. Numeracy focus
May 26
Tues Division Cross Country – Eastern Gardens
May 27
Wed Winter Lightning Premiership – Netball & T.Ball
May 28
Thurs REPORT WRITING DAY – PUPIL FREE
(NOTE CHANGE OF DAY) !!!!!!!!!
Jun 1
Mon
School Photos
Jun 2
Tues Preps visit Stinton Ave shops – 11.30-1.30pm.
Grs.3/4 Badminton Clinic
Jun 3
Wed Network Meeting - Gavan
Jun 4
Thurs Grs.5/6 Badminton Clinic
Jun 8
Mon
Queen’s Birthday Holiday
Jun 10
Wed Cybersafety Teacher/Parent Session - details later
Dear Families,
 NAPLAN WEEK: This week the year 3 and 5 children are sitting the National
Assessment regime (NAPLAN). The children will "sit" the assessments in their
normal classroom environment. We can all help these classes by:
 Not interrupting them during the assessment times.
 If your child is in years 3 and 5, have them at school on time and support
them by ensuring a good night’s sleep and support them if they are anxious.
We want them to do their best, nothing more.
 Welcome: We have welcomed the Gratton Usher family to the school
community. Elisa joins 5SJ and Thomas (2JS). I am sure we will all welcome
the family to our school.
 School Athletics: Please note that the back-up day for our cancelled Athletics
meet is Tuesday May 19. Hopefully all our generous helpers are available on
this date. Figures crossed for a sunny day!
 School Council: Last night our Council met to discuss and listen to reports
etc. This included:
 Correspondence
 Reports from Curriculum, Principal, Finance and Facilities.
 Discussion on Chaplaincy for terms 3 and 4. The decision was to again fund
the employment for the remainder of the year. Thank you for your input into
this decision.
 Cleaning Contract for 2015/2016.
We also welcomed Deb Fisher to her first meeting as a Staff Rep.
At the moment Council membership is:
President – Ben Woodman
Vice President – Phil Joyce
Secretary – Mark Alexander
Council members: Jason Renshaw, Rob Hamilton, Shaun Sleep,
Scott McCumber, Sarah Jeffreys, Deb Fisher, Gavan Welsh.
 Thank You: This week I would like to send a thank you to all our families,
extended families and community for the countless hours given to support our
students and the school. We are extremely grateful for this support in all its
forms. Hearing reading, helping with Numeracy homework, fundraising, giving
feedback and support to staff etc. The support we get is given by many and is
varied in its nature - thank you for all of it.
 Report Writing Day: Please note that our Report Writing day has been ratified
by Council for Thursday May 28. Child care is available on that day (numbers
permitting). Please contact Chloe in Out of School Care or the office to make
bookings. (Care on this day is separate from before and after school care)
 Enrolment Week / Education Week: What a busy week we have next week!
Please take the opportunities outlined below to be a part of your child’s
education :
 Tuesday 19th : Prep 2016 Tour at 9.30. Hopefully the word has filtered out
that the opportunity to look over our school for new and existing parents
begins today. Tours will start in the staffroom with a brief overview followed
by tours of the school in action.
 Tuesday night: A session will be held in the Prep rooms at 7.00-8.00pm to
outline the school’s program etc. This is predominately to give an
opportunity for those who cannot make the day tours. We have speakers
covering aspects of the school’s operation.
 Thursday 21st : The last tour for 2016 Preps starts at 2.30. Again we will be
meeting in the staffroom before having a look at the school in operation.
 Friday 22nd : Open session from 9-1am. will allow our present families the
opportunity to join in the education of their child. All are welcome into the
classroom to be part of the normal exciting day at Chilwell.
If you or families you know have a child who will turn 5 before April 30, 2016
could you please pass on these details.
 Birthdays. Happy birthday to the following students who celebrate their
birthday next week.
Thurs 14th May
Fri 15th May
Sat 16th May
Mon 18th May
Wed 20th May
Olivia C
Michael R
Arvin S
Julian C
Kalani d
George C
Sam J
Harley B
2CB
4JM
6PD
6PD
5ML
6SW
0JS
5ML
Regards,
Gavan Welsh, Principal
Additional calendar dates:
Thurs Grs. 3-6 Cybersafety session – am.
Grs.5/6 Badminton Clinic
Jun 15
Mon
Council meeting 7pm.
Jun 15-19
Planning Week
Jun 17-23
Life Education
Jun 19
Fri
Mid-Year Reports home
Jun 24
Wed 3-way Interviews (Teachers, Parents, Students)
Sept 15
Tues Concert
(advance notice)
Nov 2-4
Gr.4 Lady Northcote Camp. (advance notice)
Jun 11
School Photo Day – MONDAY 1ST JUNE
 Envelopes have been sent home today outlining the various “Parent Choice”
packages available. These range from $25.00 to $49.00.
 All students must present their own envelope to the photographer on the
Monday, even if the money is included in their brother or sister’s envelope.
 Please include correct money – No change available on Photo Day.
 All students will be included in the class group photograph.
 Family photos can be made on request – obtain a Family Photo envelope
from the office. Only children who present a family photo envelope on the
Thursday will have a family photo taken. These range from $10-$20.
 Please have your children dressed in school uniform for the photos.
 Please ensure that the photo envelope is returned to school by Wednesday
27th May.
 NOTE: Cheques should be made payable - “Southern Cross MSP”.
 Family concessions apply – please read envelopes carefully.
 All enquiries should be made to Southern Cross Master School Portraits on
5222 6747.
Photos will be taken in the morning so please ensure that your child is at school
on time to avoid any disappointment.
NAPLAN Implementation 2015
The National Assessment Program – Literacy and Numeracy (NAPLAN) tests for
the Years 3 and 5 students will be conducted this week. The results of the tests
will provide information for teachers and parents about a child’s performance in
Literacy and Numeracy and will be used, in conjunction with our school based
assessment, to support our teaching and learning programs.
As detailed below the tests have to be conducted at specific times and it is
essential that the children in Grades 3 & 5 arrive at school promptly at 8:55am to
allow adequate time for the introductory activities and the test itself. Children who
arrive late to a testing session or are away will be required to sit the test at
another time during the week.
Timetable
Wednesday 13th May
Thursday 14th May
Between 9:00–1:30
Between 9:00–11:00
Reading
Numeracy
If you have any concerns with regard to this information could you please contact
either Gavan, Jason or me as soon as possible.
Kim Hamilton and Jason Cole, NAPLAN Co-ordinators
TERM 2 PLANNER
The planning day at the end of Term 2 enabled the teachers in all learning units to
meet and plan out activities for this term. Pop the relevant days and activities on
your calendar at home. Hopefully, this forward notice also assists your budgeting
and also gives parents an update and forward warning of expenses.
Grade
Prep
Theme
Community
Community
Community
Subject AusVELS
Associated activity
Approx.
Date of
Activity
Anticipated
costs
Literacy
Maths
Literacy
Chilwell Library visit
Stinton Ave walk
Grandparents Day
28th April
2nd June
14th May
nil
$3
nil
P.E
P.E
District Cross Country
House Athletics
$5
$6
Inquiry- History
Bollard Excursion
17th May
19th May
(new date)
8th May
Grades
1&2
Grades Sport
3&4
Sport
Inquiry
Grades
5&6
Sport
Sport
Sport
P.E
P.E
P.E
District Cross Country
House Athletics
Winter Lightning Prem
17/4/15
5/5/15
20/5/15 or
27/5/15
$6
$5
$6
$6 est
Knitting for a Cause
You are invited to come along to the Art Room each Tuesday
lunchtime, starting on Tuesday 12th May, to learn how to knit.
We will be knitting small squares to make blankets for homeless members of the
Geelong Community. We hope to highlight the issue of homelessness by Yarn
Bombing some of our school structures at the end of Term 2.
Please sign up to be a part of this on the Sign Up sheet outside the Art Room.
Bring your own knitting needles and wool if possible. Once you have learnt how
to knit, we will be using a ‘pay it forward’ system, so you can teach someone else.
If you have a grandparent who knows how to knit, please invite them to come and
be part of this too.
Hot chocolate will be provided for knitting participants, tea and coffee will be
provided for Grandparents.
From Melissa (Chaplain), Mrs Fisher and Mrs McLaren
Congratulations to the following students for receiving a YCDI award for
RESILIENCE.
0OD
0JS
Isaac Robinson
Olivia McCombe
0KW
1RP
Ava Hall
Emma MirandaWilliams
Charley Stephens
Genevieve Dennis
1AE
1WH
2CB Ella Borthwick
2JS Thomas Gratton
Usher
3KH Staci Holmes
3JC Oscar Phillips
4JS
5ML
4JM Aoife Stynes
6PD
Lochie Allen
Bella Marles
5SJ Cooper Hayes
6SW Jono Fisher
Arvin Sadeghinad
Parent Contribution
A reminder to parents that this payment was due in February.
Statements have been sent home. It would be appreciated if outstanding amounts
could be paid as soon as possible.
Thank you to the families who have already paid.
(If you are experiencing difficulty with payment, contact Gavan on 52212738
to discuss payment options)
Division Cross Country Championships
Congratulations to the following students who will be representing Chilwell at the
Geelong North Division Cross Country Championships on Tuesday 26th May at
the Eastern Gardens, Geelong. More information to follow.
Age
9-10 Years
9-10 Years
9-10 Years
9-10 Years
9-10 Years
9-10 Years
9-10 Years
11 Years
11 Years
11 Years
11 Years
11 Years
12/13 Years
12/13 Years
12/13 Years
12/13 Years
Gender
Boys
Boys
Boys
Girls
Girls
Girls
Girls
Boys
Boys
Girls
Girls
Girls
Boys
Boys
Girls
Girls
Name
Jack Jelenko
Kane Reid
Seb Dell'Oro
Mia Kemp
Hannah Phung
Georgia Phung
Eden Nadorp-Goddard
Archie Bain
Sam Condie
Isabella Marles
Anna Ward
Greta Thiele
Arvin Sadeghinad
George Chomley
Alice Young
Ella Hill
New 2015 House Athletics Day for Grades 3, 4, 5 & 6– Tuesday May 19th!
On Tuesday 19th of May, the school will be holding its School House Athletics Carnival
at Landy Field, from 9:00am. to 3:00pm. Parents and guests are warmly welcome to
come along and see all the action throughout the day. Please check
next week’s newsletter for the timetable of events.
Important information.
 Clothing. This is a HOUSE sport so house colours should be
worn if possible. This adds to the spirit of the day.
 Be prepared – warm clothing (tracksuit), coat (wet weather), T.shirt/shorts for
activity.
 All children are expected to participate and all will earn valuable points for their
house.
 Please ensure that your child brings a cut lunch, snacks and drink.
 Children who suffer from asthma are expected to have and be responsible for their
inhalers.
 Correct footwear ie. sports’ shoes (no spikes).
Please feel free to come and watch to help and encourage your child efforts during the
day’s activities.
HELP!! Traditionally, hot soup and slices have been supplied by a team of
wonderful parents for the staff and helpers on the day. With the change of
day we now need someone to co-ordinate this task as the parent is now
unavailable to work commitments. Please contact Peter Blackall or the
office ASAP if you can help.
Thank You - Peter Blackall (Physical Education/Sport)
House Colours.
Marnock: Red
Balyang:
Blue
Bareena: Green
Riversdale: Yellow
++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Athletics Helper – I Can Help. (Please Return to office ASAP)
Yes, I can help out at Landy Field on Tuesday 19th of May.
Name: ________________________________ Contact No: _____________________
Child/ren’s name ___________________________ Grade/s: ____________________
Last year I helped with __________________________________ and would be happy
to do it again.
I can help between
(tick your preferred times)
9:00 -12pm
12pm -3:00pm
slice and soup team
9:00 -3:00pm
Athletics day - 2015 time table – Tuesday 19th May at Landy Field
Time
9.00
100m
200m
High
jump
Shot
put
Long
jump
9 girls
9 boys
12/13
girls
10.00
10 boys
9 girls
9 boys
10.30
10 girls
10 boys
9 girls
9 boys
11.00
11 boys
10 girls
10 boys
9 girls
9 boys
11.30
11 girls
11 boys
10 girls
10 boys
9 girls
12/13
boys
12/13
girls
1.30
Rest
11 girls
12/13
boys
12/13
girls
11 boys
10 girls
10 boys
11 girls
11 boys
10 girls
11 girls
11 boys
12/13
boys
12/13
girls
9 boys
12/13
boys
12/13
girls
11 girls
12/13
boys
LUNCH
12.00
1.00
Discus
800m run in age groups - anyone can enter and earn a point for their house.
9.30
12.30
Triple
jump
12/13
boys
12/13
girls
9 boys
11 girls
12/13
boys
12/13
girls
11 boys
10 girls
10 boys
9 girls
9 boys
12/13
girls
11 girls
11 boys
10 girls
10 boys
9 girls
9 boys
12/13
boys
11 girls
11 boys
10 girls
10 boys
9 girls
2.00
House Relay Teams
2.30
Finish
Entertainment Book - $55.00.
Valid from June 1st 2015 – May 31st 2016
Great Mother’s Day Present. Get your copy now.
A display book in the office foyer for interested families to peruse.
Please enquire at the office to purchase a book.
Prep Grandparents/Special Friends Morning
On Thursday 21st May, the Preps are inviting their Grandparents or a Special friend
to come and visit any time between 9am and 11am. The Preps are looking forward
to showing their loved ones their classrooms and the great work they’ve been
doing. Hope to see you there!
Celebrating Public Education in Victoria
17th – 23rd May, 2015
2:30 – 3:30 Thursday 21st May
Numeracy Information Session
How is Numeracy Taught at Chilwell?
Focus on: Place Value
Addition/Subtraction
Tables Facts
Other Areas
9:00 – 11:00 Friday 22nd May
Whole School Open Morning
Numeracy Focus
2016 Prep Enrolment Week.
Tours of the school.
Tuesday 19th May 9.30-10.30am. and
Thursday 21st May 2.30-3.30pm.
Information Evening Session: Tuesday 19th May 7-8pm.
*Sign in at the office, collect your visitor’s pass, then take a walk around to see the
school in action.
Special Invitation
You are invited to attend a Numeracy Information Session on Thursday 21st May
to learn how Numeracy is taught at Chilwell. This session will attempt to share
updated and modern theories in teaching Numeracy. Please indicate below if
you will attend this session. If you have a question that you would like answered
please write it below so this question can be answered.
Please Return by Monday 18th May
I ________________________________________ will attend the Numeracy
Information Session on Thursday 21st May.
I would like to know _________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Chilwell P.S. Outside School Hours Care
Term 2 – May 2015
To book or cancel care please call Chloe on 0417 014 973
Wednesday 13th May
Thursday 14th May
Friday 15th May
Monday 18th May
Tuesday 19th May
Finger knitting
Musical games
Sponge painting
Movie & popcorn
Making honey joys
EFTPOS facility is available – for payments over $10.00.
Form available at the office or from the OSHC.
IMPORTANT!!! We encourage families to keep their account in credit.
Just a reminder to all those who have a permanent after school booking. If
unable to attend please cancel before 2.30pm. to assist staff and avoid session
fee. Thanks – OOSHC Staff.
Canteen news……. OPTIONS FOR TERM 2 – see below
Orders must be into the office by 3.30 pm. Thursday – no late orders will be
accepted. Lunch will be provided on Friday.
Lunch options are as follows :
OPTION 1 Pulled chicken, lettuce roll, chips, apple, chocolate donut
OPTION 2 Ham, lettuce & chutney roll, chips, apple, red jelly delight
OPTION 3 Cheese & Bacon Roll, chips, apple, chocolate crackle
Each option $5.00
Canteen Roster – Fridays – 1.15-1.30 pm.
HELP REQUIRED !!!
Fri 15th May
Sam Visser
Kirsty McColl
nd
Fri 22 May
Sally Stansmore
Caroline Wells
th
Fri 29 May
Fri 5th June
Kirsty McColl
Pauline Braniff
th
Fri 12 June
Sam Visser
th
Fri 19 June
Sally Stansmore
Sue Grigg
th
Fri 26 June
Cate Wilson
Please try to arrange a swap if you cannot attend on the day rostered & let office
know of swap.
Secondhand Uniforms sales on Monday 18th May
There are lots of items for sale.
Time – 3.15 till 3.45pm.
We are expecting delivery today of new uniforms that have been
on order for some time.
Back orders will be completed as soon as they are received.
Grade Prep, One & Two Stars of The Week....
Matilda Allen, Hannah Renshaw, Bridie Whitcher, Jade Barwick, Milla Alstin
Will Farnell, Lily Mulroyan, Audrey Dickens
3-WAY PARENT-TEACHER-STUDENT INTERVIEWS.
In readiness for the PTO logon to secure an interview, if you have
changed your email address since February – please complete the form
below & return to the office asap.
Parent Name _____________________________________
Email address _________________________________________
Last year the Scholastic Book Fair proved very popular with parents and students
so we have rebooked it for Education Week – next week.
On sale will be a large range of books and activity sets as well as smaller sundry
items. Books for sale are usually popular titles published by Scholastic. Prices
are consistent with what you would pay if buying from a book shop or from the
Book Club.
The Book Fair will be situated in the library and will be open for browsing
and sales after school next Tuesday, Wednesday and Thursday at 3.30 till
4.30 pm.
If you are able to assist with Book Fair sales on any of the 3 nights, we would be
most appreciative of your help. If you are available to volunteer an hour of your
time, please fill in the attached form and return it to the school office this week.
Looking forward to seeing you next week at the Book Fair.
Rosemary O’Donnell and Deb Fisher.
...................................................................................................................................
Book Fair Volunteer
Name: ................................................................
Ph. …………………………..
Parent/Guardian of ............................................... ... from Grade .................
Yes! I will be able to help out with Book Fair Sales on the following afternoon:
o Tuesday, 19th May, 3.30 – 4.30 p.m.
o Wednesday, 20th May, 3.30 – 4.30 p.m.
o Thursday, 21st May, 3.30 – 4.30 p.m.
CYBER SAFETY INFORMATION SESSION….
Robbie Noggler, Leading Senior Constable Youth Resource Officer, will be running a
Parent Information Session on Wednesday June 10th from 7:00-8:30pm in the
Multipurpose Room.
Robbie will be discussing the cybersafety issues that we, as parents and carers, need to
be aware of in order to keep our children safe in the online environment.
Robbie will also visit our 3,4,5 & 6 community to talk to about cyber safety. He will
discuss cyber bullying, digital footprints, being safe online, bystanders, using social media
sites, some safety tips, meta data and the importance of using devices near parents.
Attending this session is a good way to keep up to date with what our children are
exposed to online. If you plan to attend, please register your name at the office so we can
provide adequate seating.
We look forward to seeing you there!
Cathy Burns
2016 Prep Enrolment Week
Monday 18th May-Friday 22nd May 2015
DAY SESSIONS:
Tuesday, 19th May
9.30-10.30 am. Tour
Thursday, 21st May
2.30-3.30 pm. Tour
EVENING SESSION:
TUESDAY, 19th May
7.00-8.00 p.m.
Venue – Prep Rooms (follow the signs)
The assembly point for these tours is the
foyer. Entry is via the front door facing
Pakington Street.
Mr Gavan Welsh, the School Principal
accompanied by some of our senior
students, will conduct the tour.
Mr Gavan Welsh and the Prep teachers
will explain the Prep programs and
procedures.
The session will be followed by Question
Time.
You are then welcome to stay and join us
for supper.
----------------------------------------------------------------------------------------------------------------------------
Year 2016 Enrolment.
Return only if this affects your family.
Family Name _____________________________________________
1.
We will not be at Chilwell in 2016.
2.
Sibling enrolling in 2016. Child’s Name _____________________
Name of Pre-School/Kinder ______________________________________________________
Chilwell Primary School
UNIFORM ORDER FORM @ 1/2/2014
Child's Name:……………………...………..……………………………………………………Date:…../…../…..
Grade:……………………
Phone:………………………………………………
Price
Size Quantity
Polo Shirt – Short Sleeve (Royal Blue with White Collar)
Child - size 6 to 16
$ 26.00
Adult - size 16 to 26
$ 30.00
Polo Shirt – Long Sleeve (Royal Blue with White Collar)
Child - size 6 to 16
$ 28.00
Adult - size 16 to 26
$ 33.00
Crew Neck Windcheater (Royal Blue - Round Neck)
Child - size 6 to 16
$ 27.00
Adult - size 12 to 26
$ 36.00
Rugby Top (Striped with Piping & White Collar)
Child - size 6 to 16
$ 50.00
Adult - size 16 to 26
$ 57.00
Polar Fleece Vest (Navy Blue)
Child – size 6 to 16
$ 38.00
Adult – size 14 to 20
$ 38.00
Track Pants (Navy Blue with Pockets & Double Knee)
Child – size 6 to 16
$ 22.00
Adults
$ 28.00
Track Pants (Navy Blue - Boot Leg)
Child – size 6 to 16
$ 27.00
Adults – size 14 to 26
$ 34.00
Shorts (Navy Blue - Twill)
Child - size 6 to 16
$ 26.00
Adults - size 14 to 26
$ 26.00
Shorts (Navy Blue - Rugby Knit Unisex)
Size 6 to 26
$ 21.00
Hats - (Navy Blue Wide Brimmed + Logo) Compulsory - Sunsmart Policy
Size: Small - Medium - Large
$ 11.00
Reader Bag - (Compulsory for Preps)
$ 10.00
School Bag - Back Pack
$ 43.00
TOTAL AMOUNT DUE:
(Circle)
Lay-by
Cheque
Cash
Make cheques payable to: "Chilwell Primary School"
PAYMENT WITH ORDERS IS PREFERRED
Amount
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Eftpos
1. Navy Cords and Girls blue & white check dresses can be purchased from retail
outlets.
2. Parents are encouraged to donate second hand uniforms to the Uniform Shop.
3. A kilt order is issued early in Term 1 - samples will be at the office.
Pupil-Free Day Child-Care Program – Report Writing Day
THURSDAY 28TH MAY - 9am. – 3.30pm.
At Chilwell Out of School Hours Child Care Venue
NOTE: Normal Before School Care – 7.30-8.45 am.
and
After School Care 3.30-6.00 pm. will operate –
NORMAL RATES & Child Care Benefits APPLY to these sessions
CCB does not apply to the day session
Activities include :
Cost - $35.00 per child – 9am. to 3.30pm. care.
Please ensure you return the booking form below by Friday 15th May.
Payment for the Report Writing Day must be paid prior to accessing the program.
If you have not used the Out of School Hours Care Program before, you must
complete an OOSHC enrolment form. Please see Chloe for further information.
Phone 0417 014 973. Please return this slip along with payment. Thank you.
Parent’s Signature ........................................................ Amount paid $____________________
Child’s Name
Age/Grade
Person picking up child
Special dietary requests. __________________________________________________________
_____________________________________________________________________________________
Payment by Credit Card (for amounts $10 & over)
Amount:
 Visa  Mastercard
$ …………….
3 digit Security Code:
Card Number:
Cardholder’s Name:………………………………………………… Expiry Date :
Cardholder’s Signature:…………………………………………………………………….
Reason for Payment ………………………………………………………………………..
/