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English PTA Membership Form



Jefferson Elementary PTA

Believe in Our Children, Believe in PTA

PTA Membership Sign Up Form








Parent’s Full Name:




Email Address:


Phone Number:


Child’s Name: Grade: Teacher:


Child’s Name: Grade: Teacher:


Child’s Name: Grade: Teacher:


Child’s Name: Grade: Teacher:


I would like to purchase the following:





Total Cost





  • Together We Shine Package




Includes Membership & Yearbook!








  • Jefferson Elementary PTA Membership








  • Yearbook 















Paid Via: Cash Check (provide check #) CC (provide last 4 digits of CC #)


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If paying by credit card, please make sure to add an additional 3% to the total amount to be charged.


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