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PDS PTA Membership Form 2016-2017
Thank you for joining the PDS PTA! Please use this form to help us collect the information, but still fill out the paper form (just the name and payment information) and hand that in with your payment. Thank you!
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* Indicates required question
Your Name
*
Your answer
Second adult name (if applicable)
Your answer
Relation to children/school
*
Parent(s)\Guardian(s)
Teacher(s)/Staff
Grandparent(s)
Other:
Address
Your answer
Telephone number(s)
Your answer
E-Mail Address(s)
Your answer
May we publish your information in our school directory?
*
Yes (All Info – Name, Address, Phone #, E-Mail)
Yes (Name and E-Mail Only)
No (Please Don’t Publish any Information)
Membership Tier Chosen
*
Single Person ($10)
Two People ($15)
Prideful Panther ($25) - This will include a special welcome package
Children(s) name(s), Grade(s), Teacher(s), Room Number(s)
Your answer
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