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Creekside PTA Membership Application
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Option 1
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First Name
*
Your answer
Last Name
*
Your answer
Member Type
*
Choose
Individual ($5)
Staff ($5)
Staff membership + T-shirt ($10) - FOR STAFF ONLY
Address
Your answer
Phone Number
*
Your answer
Email (can add more than one)
*
Your answer
Student #1 Name, Teacher Name, Grade
Your answer
Student #2 Name, Teacher Name, Grade
Your answer
Student #3 Name, Teacher Name, Grade
Your answer
Student #4 Name, Teacher Name, Grade
Your answer
Do you want to sponsor a teacher membership?
Choose
Yes (add a faculty payment to your parent payment in PayPal)
No
If sponsoring a teacher, indicate name below
Your answer
Add My Name the Eagle Blast (Parent Listserve)
*
yes
No
Do you want to add your name to the PAAC (Parents of African American Children) Listserve?
yes
no
Clear selection
Select all the volunteer activities that interest you (this is not a commitment)
Spring Carnival
Scholastic Book Fair
Science Fair
All Pro Dads Breakfast
International Night
Silent Auction
Fifth Grade Celebrations
Grounds/Beautification
Staff Appreciation
Boosterthon
Talent Show
Black History Night
Other:
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