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Dripping Springs Elementary

PTA Membership Form 2017-18

We invite you to connect with DSE PTA.  Annual membership dues are $10.00 per person.  $5.50 of your membership fee goes directly toward the many programs and services the PTA supports at DSES. $2.25 to Texas PTA, and $2.25 to National PTA. Please return this completed form, along with payment, to your child’s teacher or the school’s front office.

*  *  * Please Print This Form *  *  *

............................................................................................................................................................  First Name:  ___________________________________    

Last Name: ____________________________________  

Email: ________________________________________    Phone:____________________________________    Member Type:    □ Regular   □ Faculty  

Address: ______________________________________

City: ______________________________________    State:_________  Zip: _____________   ............................................................................................................................................................  Please list all your DSES children, their grade and teacher.  If more than one, please note with an * which child you would like your membership card to come home with.

Child’s Name:__________________________      Grade:   _____  Teacher:  ________________

Child’s Name:__________________________      Grade:   _____  Teacher:  ________________

Child’s Name:__________________________      Grade:   _____  Teacher:  ________________

Child’s Name:__________________________      Grade:   _____  Teacher:  ________________

Child’s Name:__________________________      Grade:   _____  Teacher:  ________________

 # of Memberships: ________ @ $10.00 each = $____________      

Donation to DSEPTA $____________ Total $____________

Payment accepted with Cash or Check made payable to DSE PTA (please staple payment to this form).

 Thank you for supporting DSE PTA!