ABCDEFGHIJKLMNOPQRSTUVWX
1
 Council Remittance Form2024-2025Date:
2
3
CouncilSanta ClaraPhone:
4
TreasurerEmail
5
6
DistrictState/Nat'lLate
7
ID #Unit Name
Members
Dues $.50 Dues $4.25Fee
Founder's Day
8
9
1078Adrian C. Wilcox High $ - $ - $- $-
10
6664Agnew Elementary PTA $ - $ - $- $-
11
1063Bowers Elem. $ - $ - $- $-
12
1064Bracher Elem. $ - $ - $- $-
13
4830Braly Elem. $ - $ - $- $-
14
1065Briarwood Elem. $ - $ - $- $-
15
1066Buchser Middle School $ - $ - $- $-
16
6500Central Park Elem. $ - $ - $- $-
17
4225George Mayne Elem. $ - $ - $- $-
18
1067Haman Elem. $ - $ - $- $-
19
6638Huerta Middle $ - $ - $- $-
20
4856Juan Cabrillo Middle $ - $ - $- $-
21
1068Kathryn Hughes $ - $ - $- $-
22
1069Laurelwood Elem. $ - $ - $- $-
23
6655MacDonald High $ - $ - $- $-
24
1070Millikin Basics Plus Elem. $ - $ - $- $-
25
6547Mission Early College High $ - $ - $- $-
26
1071Montague Elem. $ - $ - $- $-
27
1072Peterson Middle $ - $ - $- $-
28
1073Pomeroy Elem. $ - $ - $- $-
29
1074Ponderosa Elem. $ - $ - $- $-
30
1075Santa Clara High $ - $ - $- $-
31
3482Scott Lane Elem. $ - $ - $- $-
32
1076Sutter Elem. $ - $ - $- $-
33
1077Westwood Elem. $ - $ - $- $-
34
35
Total Membership0 $ - $ - $ - $ -
36
37
Sixth District Dues - $.50 per member
 $ -
38
State & National Dues - $4.25 per member
 $ -
39
Insurance Late Fee State
($25) $ -
40
Founders Day Gifts
 $
41
Other $
42
Remittance Check# $ -
43
44
Send 2 Copies to: Treasurer
45
Sixth District PTA
46
1290 Ridder Park Dr., M/C 214
47
San Jose, CA 95131-2304
48
49
A portion of the total sum sent for the National portion of PTA membership dues
50
is payment for one year’s subscription to Our Children, a magazine published
51
by the National Congress of Parents and Teachers. It will be sent to the president
52
of each local unit.
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100