Parent Information

2019 - 2020 PTA Membership Form

Parent/Guardian Information
Welcome to Grange Hall Elementary PTA! Here you will be able to submit for a PTA membership, share your communication preferences, and select any volunteer opportunities you might be interested in.

We plan to have an online directory available to PTA members this year. Please select which information you would like shared and not shared in the directory.
Primary Contact Information
Parent/Guardian Name*

First NameLast Name
Email*

Confirmation Emailexamplte@example.com
Home Phone Number*
Cell Phone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Membership Information
PTA Membership Level

Single Membership (if 1 GHES student in the household) - $8.00

Family Membership (if 2+ GHES students in the household) - $12.00

Teacher Membership (GHES teachers and staff only) - $8.00

Additional Family Membership (ex. Additonal adult family members, Corporate Sponsors) - $8.00

Information on where your PTA dues go
Membership Level*
If you would like to to donate additional funds to the PTA, please enter this amount below:
MemCost
Interested In:

Receiving PTA communicationsVolunteering during daytime activitiesVolunteering during nighttime activitiesLeading an initiativeAssisting on a projectOther
Membership Directory Opt Out:

Do not publish our Phone NumberDo not publish our AddressDo not publish our Email Address
Secondary Contact Information (Family Membership)
2nd Parent/Guardian Name

First NameLast Name
2nd Parent/Guardian Email

Confirmation Emailexamplte@example.com
2nd Parent/Guardian Cell Phone Number
Is the 2nd Parent/Guardian Contact Information (Home Phone #/Address) the same as the Primary?
2nd Parent/Guardian Home Phone Number
2nd Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Additional Comments
Student Information
1st Student's Information
Child's Name*

First NameLast Name
Child's Grade and Teacher
Enter another child*

YesNo
2nd Student's Information
Child's Name

First NameLast Name
Child's Grade and Teacher
Enter another child*

YesNo
3rd Student's Information
Child's Name

First NameLast Name
Child's Grade and Teacher
Enter another child*

YesNo
4th Student's Information
Child's Name

First NameLast Name
Child's Grade and Teacher
Enter another child*

YesNo
5th Student's Information
Child's Name

First NameLast Name
Child's Grade and Teacher
Payment Information
Total Due to GHES PTA (in $US)
Payment Method*

I will mail or send in a check/cashCredit Card
NOTE: If you wish to send in payment, please send in the total amount due, labeled PTA membership to the attention of the PTA Treasurer AND make sure your name and the name of your child/children is included with your payment.

Should be Empty:

2019 - 2020 PTA Membership Form

Primary Contact Information

Membership Information

Secondary Contact Information (Family Membership)

Student Information

1st Student's Information

2nd Student's Information

3rd Student's Information

4th Student's Information

5th Student's Information

Payment Information

Credit Card