Idaho Pta Membership Dues Remittance Form printable pdf download

IDAHO PTA

MEMBERSHIP DUES REMITTANCE FORM

(This form should accompany all dues sent to Idaho PTA )

For the Year ________________

Date Submitted______________

NAME

of PTA/PTSA Unit: ___________________________________ Idaho PTA Region (1-9): _____

Local Unit Record Number (LUR):

All units begin with at least one zero and

should be eight digits in length - also

0 0 6

4 7 0 1

referred to as National ID #.

Example: 8 digits in length

Local Unit Membership Chairman: ________________________________________________

Address/City/State/Zip: ________________________________________________

Phone: ___________________________________

Email: ___________________________________

Local Unit Treasurer: ____________________________________Phone: _________________

Remittance:

Number of Members for this report at $7.50:_______ = $________

Number of Student Members at $4.00: ________=$________

Total number of members:________=$________

Approximate Number of Students enrolled at your School: ________

Please email your members in an excel spreadsheet with the following information; First and

last name, and email address to

This form should accompany any money submitted for membership dues.

Awards and Reflections participation depend upon the first membership installment being

post marked no later than November 1st.

First remittance due: November 1st

After the first installment please send membership dues in monthly.

**Reminder each local PTA unit is required to have a minimum of 5 members**

Please send: check (remember two (2) signers), roster, and this membership remittance form to:

Idaho PTA

1655 West Fairview Avenue, Suite 109, Boise, Idaho 83702

Questions? Contact your Region Director or

the State Office at 208-344-0851 or

For Office Use Only:

Amount Received: __________

Cc:_____Dues Report:_______

Copy this form to reuse during the year.

Date Received: __________

Check #: __________

Idaho Pta Membership Dues Remittance Form