Exhibit

E 1230

Community Relations

School-Connected Organizations

SCHOOL-CONNECTED ORGANIZATIONS ANNUAL AUTHORIZATION

NAME OF ORGANIZATION________________________________________________________

DATE OF APPLICATION ________________________________________________________

MEMBERSHIP GUIDELINES OR

QUALIFICATIONS______________________________________________________________

____________________________________________________________________________

OFFICERS:

______________________ ________________ _______________ _________________

NAME TITLE ADDRESS PHONE

______________________ ________________ _______________ _________________

NAME TITLE ADDRESS PHONE

______________________ ________________ _______________ _________________

NAME TITLE ADDRESS PHONE

______________________ ________________ _______________ _________________

NAME TITLE ADDRESS PHONE

______________________ ________________ _______________ _________________

NAME TITLE ADDRESS PHONE

PURPOSE OF ORGANIZATION:_____________________________________________________

_____________________________________________________________________________

ORGANIZATION OBJECTIVES: _____________________________________________________

_____________________________________________________________________________

NAME OF BANK:________________________________________________________________

AUTHORIZED SIGNERS ON THE ACCOUNT

_______________________________ ______________________

NAME TITLE

_______________________________ ______________________

NAME TITLE

_______________________________ ______________________

NAME TITLE

DESIRED USE OF MONEY REMAINING AT THE END OF THE YEAR IF THE ORGANIZATION DOES NOT CONTINUE:

EVIDENCE OF INSURANCE AS REQUIRED BYLAW ATTACHED: ______

BYLAWS OF THE ORGANIZATION ATTACHED: ______

COPY OF ARTICLES OF INCORPORATION ATTACHED: ______

COPY OF IRS 501(c)(3) STATUS FORM ATTACHED (IF APPLICABLE): ______

AUTHORIZATION APPROVAL:

_____________________________________

SIGNATURE

______________________________________________________________

NAME/TITLE

Exhibit PALOS VERDES PENINSULA UNIFIED SCHOOL DISTRICT

version: December 11, 2000 Palos Verdes Estates, California