AECPTA Membership Form
Our membership year runs from August 1-July 31. Dues are $24.00 per family (with one voting member). After filling out this form, you will need to visit www.joinpta.org to pay your dues. Please make sure to select Allen Early Childhood PTA. Thank you!
Type of Membership I am Applying For *
Required
First and Last Name *
Your answer
Your Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Your Email *
Your answer
Cell Phone Number *
Your answer
Home Phone Number
Your answer
Your Date of Birth (MM/DD/YY) *
Your answer
Your Spouse's Name First & Last *
Your answer
Your Spouse's Cell Phone *
Your answer
Your Spouse's Date of Birth (MM/DD/YY) *
Your answer
Child #1 Name (First & Last) *
Your answer
Child #1 Birthdate (MM/DD/YY) *
Your answer
Child #2 Name (First & Last)
Your answer
Child #2 Birthdate (MM/DD/YY)
Your answer
Child #3 Name (First & Last)
Your answer
Child #3 Birthdate (MM/DD/YY)
Your answer
Child #4 Name (First & Last)
Your answer
Child #4 Birthdate (MM/DD/YY)
Your answer
Child #5 Name (First & Last)
Your answer
Child #5 Birthdate (MM/DD/YY)
Your answer
How did you hear about us? *
Required
If a friend or current member referred you please tell us their name.
(Or please say more specifically where you heard about us - which preschool/business/website/etc.)
Your answer
Ways to Volunteer: *
Which activities are you interested in getting more information on or volunteering for?
Required
We value your opinion, if you have ideas for activities, please list them here.
Ideas for adult social/couples, children's programs/field trips, topics/educational speakers, or other activities:
Your answer
A digital membership directory is distributed to current members only. Please list the information you would like included in the directory. *
Yes
No
Home Address
Your Email
Your Cell Phone
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.