PHSC General Membership Form
The Philadelphia Home and School Council welcomes all Home and School Associations to another school year, 2017- 2018.

The Philadelphia Home and School Council requires all Associations to complete the online membership form, signature page and to pay dues annually in order to become a member in a Home and School Association, after which you will receive vital information from your Council Representative. Dues will remain at $150 for the academic school year and should be submitted to the Council office no later than December 31, 2017, via mail or hand delivery. ALL checks submitted for payment of dues MUST must have two (2) signatures, and PHSC recommends that there are three (3) signatures on file at the bank.
We require all of the information on the form to be completed in full, and when you have completed, it will be submitted electronically to the Office, but you must mail in the signature page along with your Membership Dues. The personal information required must be given, as that information is for insurance purposes, and in the event we need to personally contact any member of The Executive Board.
Payments are to be made by check or money order payable to: Philadelphia Home and School Council.

Philadelphia Home and School Council
440 N. Broad Street, Rm. 115
Philadelphia PA 19130

Member Associations will receive vital and updated information from their Council Representatives concerning any changes that are to be expected in The School District. Your Association will receive the following, with the payment of dues:
Learning Network Information
· Monthly General Membership and Region Meetings
· Council Calendar of Events
· *Insurance Certificates for Fundraising Events, upon request; and
· Workshop Training
*This certificate is proof that your Member Association is covered for all events held by The Member Association on or off School Property.

A viable Association must have a minimum of three (3) duly elected officers who must include the following:
One (1) President, One (1) Treasurer, One (1) Vice President or One (1) Recording Secretary
The first event held should be a Membership Drive (if you are a new Association with no start-up money available). This event will enable you to pay your dues. Your dues are to be sent in upon receipt of this notice, but no later than December 31, 2017. This is to ensure your rights as a viable and sanctioned Association, and enable your Association to vote for Officers in The Philadelphia Home and School Council Election held in 2018. If you are having difficulties, please immediately notify your Council Representative, and request their assistance.
May we have a successful, informative year of working together for all of our children!

School Information
School Name
Your answer
Name of Association:
Your answer
School Address:
Your answer
School Telephone Number:
Your answer
Fax Number:
Your answer
Principal of School:
Your answer
Officers' Information
Date of when Home & School officers were elected to Office:
Your answer
Date of when Home & School officers were installed:
Your answer
President's Information
(P) represent's "President"
(P) Name:
First and Last
Your answer
(P) Home Address:
Include zip code
Your answer
(P) Cellphone Number:
Your answer
(P) Are you employed by the School District of Philadelphia?
(P) E-mail:
Your answer
(P) Child/Children who attend this school:
Your answer
(P) Select the grade(s) your child or children are in:
Your answer
Vice President's Information
(VP) represent's "Vice President"
(VP) Name
First and Last
Your answer
(VP) Home Address:
Include zip code
Your answer
(VP) Cellphone Number:
Your answer
(VP) Are you employed by the School District of Philadelphia?
(VP) E-mail:
Your answer
(VP) Child/Children who attend this school:
Your answer
(VP) Select the grade(s) your child or children are in:
Your answer
Second Vice President's Information
(VP2) represent's " Second Vice President"
(VP2) Name
First and Last
Your answer
(VP2) Home Address:
Include zip code
Your answer
(VP2) Cellphone Number:
Your answer
(VP2) Are you employed by the School District of Philadelphia?
(VP2) E-mail:
Your answer
(VP2) Child/Children who attend this school:
Your answer
(VP2) Select the grade(s) your child or children are in:
Your answer
Third Vice President's Information
(VP3) represent's " Third Vice President"
(VP3) Name
First and Last
Your answer
(VP3) Home Address:
Include zip code
Your answer
(VP3) Cellphone Number:
Your answer
(VP3) Are you employed by the School District of Philadelphia?
(VP3) E-mail:
Your answer
(VP3) Child/Children who attend this school:
Your answer
(VP3) Select the grade(s) your child or children are in:
Your answer
Forth Vice President's Information
(VP4) represent's " Forth Vice President"
(VP4) Name
First and Last
Your answer
(VP4) Home Address:
Include zip code
Your answer
(VP4) Cellphone Number:
Your answer
(VP4) Are you employed by the School District of Philadelphia?
(VP4) E-mail:
Your answer
(VP4) Child/Children who attend this school:
Your answer
(VP4) Select the grade(s) your child or children are in:
Your answer
Treasurer's Information
(T) represent's "Treasurer"
(T) Name
First and Last
Your answer
(T) Home Address:
Include zip code
Your answer
(T) Cellphone Number:
Your answer
(T) Are you employed by the School District of Philadelphia?
(T) E-mail:
Your answer
(T) Child/Children who attend this school:
Your answer
(T) Select the grade(s) your child or children are in:
Your answer
Recording Secretary's Information
(RS) represents "Recording Secretary"
(RS) Name
First and Last
Your answer
(RS) Home Address:
Include zip code
Your answer
(RS) Cellphone Number:
Your answer
(RS) Are you employed by the School District of Philadelphia?
(RS) E-mail:
Your answer
(RS) Child/Children who attend this school:
Your answer
(RS) Select the grade(s) your child or children are in:
Your answer
Corresponding Secretary's Information
(CS) represents "Corresponding Secretary"
(CS) Name
First and Last
Your answer
(CS) Home Address:
Include zip code
Your answer
(CS) Cellphone Number:
Your answer
(CS) Are you employed by the School District of Philadelphia?
(CS) E-mail:
Your answer
(CS) Child/Children who attend this school:
Your answer
(CS) Select the grade(s) your child or children are in:
Your answer
** ALL PERSONAL INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL AND WILL NOT BE SHARED WITH ANY OTHER ORGANIZATION! **
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