KPGT On-Site Membership Form
Annual Dues for 2018-2019 School Year:
$20 for Family Membership
$10 for Katy ISD A+ Educators (Teachers, Counselors, Administrators)

ONLINE MEMBERSHIP APPLICATION REQUIRES PAYMENT BY PAY PAL

PLEASE NOTE THAT MEMBERSHIP FEES ARE NON-REFUNDABLE

Residence in Katy ISD, or having a child in the KISD G/T program, is not a requirement for membership. Because of funding and facility restrictions, participation in some events will be restricted to KISD identified G/T students.
Publicity Consent *
Note: if you do NOT agree to the publicity release below, please download the printable form and apply for membership by mail. Any photographs of children used on the KPGT website are carefully chosen so they do not include the child's name or the name of the school. I hereby consent that any photographs taken in the course of a KPGT event may be used by KPGT for the purposes of publicity and promotion for that organization, including use in printed material (newsletters, brochures) and electronic media
Required
ADULT MEMBER INFORMATION
Please indicate your role in the G/T community *
Primary Adult Last Name *
Primary Adult First Name *
Primary Adult Phone Number *
Primary Adult Email Address *
Would you like to be contacted via email about volunteering for KPGT?
Family Street Address *
City *
ZIP Code *
Secondary Adult Last Name
Secondary Adult First Name
Secondary Adult Phone Number
Secondary Adult Email Address
Would you like to be contacted via email about volunteering for KPGT?
G/T Identified Children
Please enter the information below for your KISD GT-Identified students only.
Student #1 First Name
Student #1 Last Name
Student #1 Grade in School Year 2018-2019
Student #1 KISD Campus
Student #2 First Name
Student #2 Last Name
Student #2 Grade in School Year 2018-2019
Student #2 KISD Campus
Student #3 First Name
Student #3 Last Name
Student #3 Grade in School Year 2018-2019
Student #3 KISD Campus
Sponsorships
If you would like to sponsor a KISD staff member's KPGT membership, you may do so at $10 per sponsored member. Sponsorship raises staff awareness of G/T issues and needs, helps keep the staff member informed about KPGT activities and opportunities, and allows them to participate at member rates.
Staff Member's First Name
Staff Member's Last Name
Staff Member's Campus
Staff Member's Email address (if known)
Additional Donations
If desired, you may make a donation beyond your membership dues. All donations are tax-deductible and directly fund KPGT programs and services benefitting KISD's G/T students.
Friend: $1-$74
Supporter: $75-$149
Advocate: $150-$299
Patron: $300-$499
Benefactor: $500+
Total
You may pay for your membership via PayPal or with a credit card. After submitting this form, your confirmation screen will have a link to complete payment for your membership registration.

NOTE: You do not have to have a PayPal account to complete the transaction. PayPal will allow you to pay via credit card if desired.
Total for Membership *
Total for Sponsorship (if applicable, $10 per staff member)
Total for Additional Donation (if applicable)
Grand Total of above items *
Please remember this amount for your Pay Pal transaction. Please note that membership fees and other donations are non-refundable
Name on Pay Pal or credit card account *
Comments
Thank you for your support of KPGT!
If you have comments or have additional GT students or Sponsorship information, please enter it below.
Submit
Never submit passwords through Google Forms.
This form was created inside of Katy Parents of Gifted and Talented Students, Inc.. Report Abuse
Google Forms