Membership Registration Form

Parent First Name

This is a required question

Parent Last Name

This is a required question

Telephone Number

This is a required question

Email Address (1)

This is a required question

Email Address (2)

This is a required question

Student Name (1) (if teacher, enter TEACHER)

This is a required question

Graduation Year

This is a required question

Student Name (2)

This is a required question

Graduation Year for Student 2

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Remarks / Additional Student Information

This is a required question

Membership / Donations

Family Membership @ $20.00 each
Teacher / Classroom Donation
Grad Night Donation
General Fundraising Donation

This is a required question