Dobson Home and School Membership Form 2016-2017
Annual dues are $5.00 per family; the money goes toward OUR dues to the Philadelphia Home & School Council.
Please send your membership dues into Dobson with your child in an envelope labeled with your family's name;
or pay in person to any HSA Board Member.
Child[ren] presently attending James Dobson & Homeroom #'s, if none type N/A
"Ella Maria Bratina, 107 OR Mrs. Heyward"
Your answer
Parent / Guardian / Teacher / Community / Organization Name:
Your answer
Please select the title that best describes you:
Required
Phone Number:
Your answer
E-mail Address:
Your answer
Events with which I would like to help, depending on my schedule:
For more information about each of these events, please see visit our website www.jamesdobsonhsa.com. We look forward to working with you.
FOR HSA OFFICERS ONLY - Have dues been paid?
HSA Officers only please
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