Family Membership Form (2016-2017)


All information will be kept confidential and used solely for the purpose of communicating members of Durham PAGE regarding programming and issues related to gifted children.

    Membership Type & Dues

    Dues will NOT be collected for the 2016-2017 school year!
    This is a required question
    This is a required question
    This is a required question

    Parent/Guardian Information

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Student Information

    Child 1

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Child 2

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Child 3

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Activities

    This is a required question

    Committees

    This is a required question

    Connections, Expertise, and Special Interests

    This is a required question

    How did you learn about Durham PAGE?

    This is a required question