Welcome to the Coolidge PTA Membership Form
This form is being use to collect information for your PTA Membership AND with your consent will allow the PTA to publish your contact information on MemberHub.

Your PTA membership will be confirmed when you submit your dues to the PTA. If we do not receive your dues, you will NOT be considered a PTA member.

Please send your dues via cash or check payable to "COOLIDGE PTA" to school in an envelope labeled "PTA Membership." You MUST also include your child's name AND teacher on the envelope.

Parent/Guardian Information
What level of PTA membership are you supporting? *
Please send your dues via cash or check payable to "COOLIDGE PTA" to school in an envelope labeled "PTA Membership." You MUST also include your child's name AND teacher on the envelope.
Required
Parent/Guardian #1 First Name *
Your answer
Parent/Guardian #1 Last Name *
Your answer
Home Phone *
Your answer
Cell Phone
Your answer
Email *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Parent/Guardian #2 First Name
Your answer
Parent/Guardian #2 Last Name
Your answer
Home Phone #2
(If different than above)
Your answer
Cell Phone #2
(If different than above)
Your answer
Email #2
Your answer
Address #2
(If different than above)
Your answer
City #2
(If different than above)
Your answer
Zip Code #2
(If different than above)
Your answer
Student Information
Please ONLY Include Coolidge Elementary Students

**If you are a Teacher, Staff or Community Member and do not have a student at Coolidge, please enter Staff or Community Member in the Child Name field and choose Coolidge Staff or Community Member from the drop down.

Child #1 First & Last Name *
Your answer
Child #1 Grade & Teacher *
Child #2 First & Last Name
Your answer
Child #2 Grade & Teacher
Child #3 First & Last Name
Your answer
Child #3 Grade & Teacher
Child #4 First & Last Name
Your answer
Child #4 Grade & Teacher
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