PTA membershiP APPlicATion
Member of:
PTA Welcomes you As A member, PleAse comPleTe The informATion beloW:
Primary role: o Parent/Guardian o Grandparent o Teacher/Staff o Other________________________
name o mr. o ms. o mrs. : ___________________________________________________________
Address: __________________________________________________________________________
home: ___________________________________ Mobile: __________________________________
email: _____________________________ o Please add me to the PTA email list for updates and news.
student(s):
Name:________________________________Grade:________________Teacher:________________
Name:________________________________Grade:________________Teacher:________________
Name:________________________________Grade:________________Teacher:________________
i am interested in volunteering for PTA activities. Please send me information on how to participate in PTA.
o
PAymenT informATion
:
(dues include membership in National PTA and your state PTA)
Annual Membership Dues: $
Please make checks payable to:
Mailing Address:
PTA membershiP benefiTs include:
•
hertz:
Savings of up to 20%.
•
metlife Auto & home
:
A group insurance program that comes with special savings and benefits.
®
•
sharp electronics corporation:
Special purchase opportunities on AQUOS liquid crystal
televisions and other audio, video, home appliance and home office products.
•
social scout
:
Discounts on an online Parental Intelligence System.
™
•
T-mobile:
Discounts on wireless mobile service and equipment.
for more informATion conTAcT:
Payment Method: o Cash o Check—check # __________Date:______________
locAl office use:
Member of: