Request edit access
2018-2019 Arkansas PTA Membership Dues Remittance Form
Dues remitted to Arkansas PTA include the portion called “National Dues” that Arkansas PTA remits to National PTA ($2.25) and the portion that Arkansas PTA uses to provide training and support for all PTAs in Arkansas called “Arkansas Dues” ($1.00). This is the total of $3.25 per member.

You will receive an email confirmation of your responses to print and submit with your check payment or you can click the link at the conclusion of this form, and on our website, to submit your payment online. If you do not see an email confirmation, please check your email's spam file.

A membership list is required to be submitted with this form and check. Arkansas PTA encourages all PTAs to submit a list of members and their contact information to Arkansas PTA, so that we can better communicate with all members. Your contact information will not be given to third party organizations. We ask that member name, email and phone number are included. We do know that not all members have emails and phone numbers. Please submit all that you have available.

Deadlines: Sept. 30 (Early Bird) Nov. 1 (Initial Dues) March 1 (Final Dues).
Completion of this form and paid dues must be postmarked / time-stamped by the due date to be eligible for awards.

Email address *
Name of Unit: *
Use complete unit name, including type (i.e., Elementary, Middle School, etc.).
Street Address: *
City: *
Zip Code: *
Region: *
Submitter's Contact Name: *
Submitter's Position within this PTA *
Submitter's Contact Email: *
Submitter's Phone Number: *
Number of new Memberships you are submitting *
Please enter the number of paid Members and submit payment @ $3.25 per member (ARPTA & NPTA dues)
Membership listing
Please send a list of member's name and email address. This is not required but highly recommended, so members can enjoy their full membership benefits from Arkansas PTA.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service