MS HS HSA Enrollment Form
Email address *
Parent First Name
Your answer
Parent Last Name
Your answer
Children Living In Your Household
In an effort to streamline the process of opting parents in to the HSA emails when children are entering 6th grade and 9th grade, we are collecting info so that we can auto-add you to the list when your child enters Middle and HIgh school. So please list all children in the Household who will attend Glen Rock schools.
FOR 2019-2020 SCHOOL YEAR
PLEASE PROVIDE NAMES OF YOUR CHILDREN ATTENDING GR SCHOOLS
CHILD 1 - FIRST NAME, LAST NAME, Grade *
Your answer
CHILD 2 - FIRST NAME, LAST NAME, Grade
Your answer
CHILD 3 - FIRST NAME, LAST NAME, Grade
Your answer
CHILD 4 - FIRST NAME, LAST NAME, Grade
Your answer
CHILD 5 - FIRST NAME, LAST NAME, Grade
Your answer
VOLUNTEER OPPORTUNITIES
If you are interested in joining any of these committees, please check the appropriate box
Please contact me to help with the following committees
Interested in Chairing
Join committee
Fundraising
Health and Wellness Events
MS HSA Events
HS HSA Events
Staff Recognition Events
HSA Dues Payment
Dues are $25/year for the MS/HS HSA. You are not a member until dues are paid via the link that will come up when you Submit this form. To eliminate any confusion, please list the name in the space below that will correspond with the credit card you are using to pay the dues. THANKS!
First Name on Credit Card *
Your answer
Last Name on Credit Card *
Your answer
Phone Number To Reach With Questions *
Your answer
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