MEMBERSHIP FORM 2017-2018 SCHOOL YEAR MEMBER INFORMATION All information will remain confidential and is collected for membership verification purposes only.Membership Type: Parent/Guardian Faculty Alumni Community Member Name / Member 1: First Last Phone / Member 1:Email / Member 1: Name / Member 2: First Last Phone / Member 2:Email / Member 2: Address Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Student Name First Last Student Name 2 First Last Student Name 3 First Last Teacher Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. Last Teacher 2 Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. Last Teacher 3 Prefix Mr.Mrs.MissMs.Dr.Prof.Rev. Last PAYMENT INFORMATION Annual PTA Membership Dues are $15 per adult; you must be a paid member to vote. The PTA year runs October 1-September 30.PTA Membership 2017-18PTA Membership 2017-18PTA Membership 2017-18$15 per number of adultsPlease enter a value greater than or equal to 1. Maury Annual Fund DonationAnnual Fund Donation (2017-18)Acorn ($50-149)Please enter a value between 50 and 149.Seedling ($150-299)Please enter a value between 150 and 299.Sapling ($300-499)Please enter a value between 300 and 499.Evergreen ($500+)Please enter a value greater than or equal to 500. This iframe contains the logic required to handle Ajax powered Gravity Forms.