2019-20 CW HSA Membership Form
Please fill out the following to become a member of the Cook-Wissahickon HSA. Please note, your information will all be private and will not be shared with any third parties. After you submit you'll see instructions for donating via Paypal or by check or cash if you'd like! Thanks so much for your involvement - we're looking forward to a great year!
Parent/Guardian 1 First Name: *
Parent/Guardian 1 Last Name: *
Email *
Parent/Guardian 2 Name
Email
Student 1 First Name (If non-guardian member, please type N/A) *
Student 1 Last (If non-guardian member, please type N/A) *
Student 1 Grade *
Student 1 Homeroom Teacher
Student 2 First Name
Student 2 Last Name
Student 2 Grade
Student 2 Homeroom Teacher
Student 3 First Name
Student 3 Last Name
Student 3 Grade
Student 3 Homeroom Teacher
Please add any additional student names/grades here.
Do you wish to receive HSA news and announcements *
Are you interested in being contacted specifically for for any of the following volunteer needs?
Please see instructions for paying for your HSA membership via Paypal or cash or check after you submit your responses! Suggested dues are $5 per family. Any additional donations are appreciated! Thanks! Questions about payment? Email cookwissahickontreasurer@gmail.com
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