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English Membership Page

English PTA Membership Form

  

 

Jefferson Elementary PTA

Believe in Our Children, Believe in PTA

PTA Membership Sign Up Form

 

 

 

 

 

Date:

 

Parent’s Full Name:

 

Address:

 

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:

 

Description

Cost

Quantity

Total Cost

 

 

 

 

  • Together We Shine Package

$30.00

 

 

Includes Membership & Yearbook!

 

 

 

 

 

 

 

  • Jefferson Elementary PTA Membership

$10.00

 

 

 

 

 

 

  • Yearbook 

$20.00

 

 

 

 

 

 

Total

 

 

 

 

 

 

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

 

Total Amount Received Additional Amt Charged for CC Fees

 

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

 

Order Taken By: