KPGT On-Site Membership Form
Annual Dues for 2017-2018 School Year:
$20 for Family Membership
$10 for Katy ISD A+ Educators (Teachers, Counselors, Administrators)

ONLINE MEMBERSHIP APPLICATION REQUIRES PAYMENT BY PAY PAL

PLEASE NOTE THAT MEMBERSHIP FEES ARE NON-REFUNDABLE

Residence in Katy ISD, or having a child in the KISD G/T program, is not a requirement for membership. Because of funding and facility restrictions, participation in some events will be restricted to KISD identified G/T students.

Publicity Consent
Note: if you do NOT agree to the publicity release below, please download the printable form and apply for membership by mail. Any photographs of children used on the KPGT website are carefully chosen so they do not include the child's name or the name of the school. I hereby consent that any photographs taken in the course of a KPGT event may be used by KPGT for the purposes of publicity and promotion for that organization, including use in printed material (newsletters, brochures) and electronic media
Required
ADULT MEMBER INFORMATION
Please indicate your role in the G/T community
Primary Adult Last Name
Your answer
Primary Adult First Name
Your answer
Primary Adult Phone Number
Your answer
Primary Adult Email Address
Your answer
Would you like to be contacted via email about volunteering for KPGT?
Family Street Address
Your answer
City
Your answer
ZIP Code
Your answer
Secondary Adult Last Name
Your answer
Secondary Adult First Name
Your answer
Secondary Adult Phone Number
Your answer
Secondary Adult Email Address
Your answer
Would you like to be contacted via email about volunteering for KPGT?
G/T Identified Children
Please enter the information below for your KISD GT-Identified students only.
Student #1 First Name
Your answer
Student #1 Last Name
Your answer
Student #1 Grade in School Year 2016-2017
Your answer
Student #1 KISD Campus
Student #2 First Name
Your answer
Student #2 Last Name
Your answer
Student #2 Grade in School Year 2016-2017
Your answer
Student #2 KISD Campus
Student #3 First Name
Your answer
Student #3 Last Name
Your answer
Student #3 Grade in School Year 2016-2017
Your answer
Student #3 KISD Campus
Sponsorships
If you would like to sponsor a KISD staff member's KPGT membership, you may do so at $10 per sponsored member. Sponsorship raises staff awareness of G/T issues and needs, helps keep the staff member informed about KPGT activities and opportunities, and allows them to participate at member rates.
Staff Member's First Name
Your answer
Staff Member's Last Name
Your answer
Staff Member's Campus
Your answer
Staff Member's Email address (if known)
Your answer
Additional Donations
If desired, you may make a donation beyond your membership dues. All donations are tax-deductible and directly fund KPGT programs and services benefitting KISD's G/T students.
Friend: $1-$74
Supporter: $75-$149
Advocate: $150-$299
Patron: $300-$499
Benefactor: $500+
Total
You may pay for your membership via PayPal or with a credit card. After submitting this form, your confirmation screen will have a link to complete payment for your membership registration.

NOTE: You do not have to have a PayPal account to complete the transaction. PayPal will allow you to pay via credit card if desired.

Total for Membership
Total for Sponsorship (if applicable, $10 per staff member)
Your answer
Total for Additional Donation (if applicable)
Your answer
Grand Total of above items
Please remember this amount for your Pay Pal transaction. Please note that membership fees and other donations are non-refundable
Your answer
Name on Pay Pal or credit card account
Your answer
Comments
Thank you for your support of KPGT!
If you have comments or have additional GT students or Sponsorship information, please enter it below.
Your answer
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