PTA Membership Application

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Candalaria Elementary School's Parent Teacher Association (PTA) is a group of parents, grandparents, guardians, teachers, staff, administrators, and community members who work together to enrich our students' education and elementary school experience.

Membership in Candalaria PTA needs to be renewed annually.

Please complete this form and submit your annual membership dues following the instructions provided below.

Scholarships are available in cases of financial hardship.

First Name *

Last Name *

Last name of the parent or person completing this application.

Email *

Email address of the person completing this application.

Phone Number *

Phone number of the person completing this application.

We are exploring texting communication option. Are you interested in receiving text messages from PTA?

Yes

Maybe

Clear selection

First Name (Parent/Guardian #2)

First name of the second parent or guardian. Please complete if applying as a family.

Last Name (Parent/Guardian #2)

Last name of the second parent or guardian. Please complete if applying as a family.

Email (Parent/Guardian #2)

Please enter the email address of the second parent or guardian if they would like to receive the PTA Newsletter.

Phone Number (Parent/Guardian #2)

Please enter the phone number of the second parent or guardian if they are interested in volunteering.

Mailing Address

Please select one: *

Parent/Guardian

Teacher

Community Member

School Staff

Business

Other

Willing to volunteer? *

Please submit your annual dues payment via PayPal for Candalaria Elementary School PTA unless you have requested a scholarship. paypal.me/CandalariaPTA *

Candalaria PTA is a 501c3 not-for-profit organization and is registered with the Oregon Department of Justice. Your membership dues are tax-deductible as a charitable contribution with the IRS.

I paid $15.00 via paypal.me/candalariapta (individual membership)

I paid $25.00 via paypal.me/candalariapta (2 person/household membership)

I would like to also provide a scholarship of $15 or $25 to help someone in need via paypal.me/candalariapta

I will mail or drop off a check (Please make check payable to "Candalaria Elementary PTA" and mail to 935 Hansen Ave S, Salem, OR 97302 or drop off at Candalaria Elementary.)

I request an individual membership scholarship (if available) due to financial hardship.

I request a household (2 person) membership scholarship (if available) due to financial hardship.

Required

Please indicate the grade of your Candalaria Elementary School student(s).

Kindergarten

First

Second

Third

Fourth

Fifth

Student #1

Student #2

Student #3

Student #4

Student #5

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