Champe PTSA Membership Form 2022

Champe PTSA Membership Form

2021-22 Application for Membership
Thank you for your interest in the PTSA at John Champe High School.

We are a non-profit organization of Parents, Teachers (& Staff) and Students
-- ONE team aimed at improving the JCHS educational experience.

Your membership and support throughout the year helps underwrite many activities conducted by our PTSA to support the John Champe HS community. Our members may give time as volunteers or help us by reducing the financial burden of our programs.

And yes, ALUMNI families to welcome to join. Graduating Knights is our mission and legacy.

To explore examples of PTSA support . . . . . . . . . Click Here ➡️
Examples of past PTSA support that ultimately benefits our students include:
- Providing low cost SAT/ACT mock tests, including the opportunity for parents to see a data breakdown of strengths and weaknesses.
- Subsidizing special purpose programs in partnership with Champe Counseling e.g. student yoga, sources of strength, training, conferences etc.
- Provided financial assistance to support renovation of two JCHS Courtyards allowing students and staff a secure outdoor space for learning.
- Co-sponsored with patrons a Brickyard for students/graduating Knight families and purchased Champe benches.
- Offering grants or Grad Scholarships.
- Organizing Teacher appreciation events.
- Supporting PTSA member teachers who apply for reimbursement of unfunded classroom expenses.
- Partnering with VDoT and LCPS on obtaining traffic signal timing changes at Conejo entrance stoplight 🚦 at Northstar Blvd.
- Supporting teacher initiatives e.g. fishing program, Science Lab material, Special Ed.
- Defraying cost for Drama production costumes.
- Advocating for traffic and pedestrian safety on and around Champe campus, partnering with VDoT, LCSO, County government & LCPS.
- Publishing Newsletter keeping parents informed.
- Hosting Principal reports at meetings.
- Partnering with VDoT on Goshen Road grading.

Primary Member
Name:*

First NameM.I.Last NameSuffix
E-mail address:
Newsletter?
also for E-Blast reminders.
Phone Number:
For rare infrequent use.

Street Address Info . . . . . . . . . . . . . Click to Collapse/Expand ➡️
Address:

Street Address

Suite / Address Line 2

CityState

Zip Code

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Membership Type:*

PARENT - Adult ($15)TEACHER - Staff ($10)STUDENT Only ($10)FAMILY ($25)
Add Spouse?

YESNo
Total Students?
Select the total # of students you are registering.

Student Info
Student Name:

First NameM.I.Last NameSuffix
Class Year [YY]:*
Last 2 digits for graduating class year.
Independent Membership?
Students are welcome and can participate in our PTSA. Students must be members to apply for scholarships. They are included with a Family membership as long as you provide their name and class year. Select "Yes" if applying as a Student individually or "No" if simply providing reference information so we understand what grade your student is in.
Student Email Address:
squire@ROUNDTABLE.com

SPOUSE Member
Additional ADULT Member

First NameM.I.Last NameSuffix
Email:
example@example.com

Additional Students
Additional Student Member 2

First NameM.I.Last NameSuffix
Class Year [YY]:
Last 2 digits for graduating class year.
Email:
example@example.com
Additional Student Member 3

First NameM.I.Last NameSuffix
Class Year [YY]:
Last 2 digits for graduating class year.
Email:
example@example.com

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Remarks:
Optional