Chaboya Middle School PTSA Membership & Donation Form

Dear Parents, Chaboya Staff and Business Partners,

Chaboya PTSA welcomes you to the 2020-2021 school year! While we are all adjusting to Distance learning,there are still many programs that the PTSA plans to support. We need EVERYONE'S help to fill the ever increasing holes left by the state budget cuts to ensure that our children receive a quality education.

This year, the Chaboya PTSA has budgeted approximately $10,395 for programs and materials that directly benefit our students. (Note that the final amount will be determined by the donations received). Items funded by PTSA are not in the school district's budget, so they are only available at Chaboya due to your direct and generous contributions. The most helpful donation amount per student for Chaboya Middle School would be $150 and above. However, any amount that you can donate is greatly appreciated. The PTSA thanks you in advance for your tremendous support! Go Colts!

The focus of PTSA support is in the following areas this year - specific funding amounts vary year to year, based on school priorities:

- Classroom Instructional Materials/Technology
- Student Enrichment (which includes Club Funding)

The Chaboya PTSA is a group of parents, students, teachers and staff devoted to the educational success of every child at Chaboya Middle School. Chaboya PTSA funds provide our students with many fun and educational services. For more details, please visit https://tinyurl.com/ChaboyaPTSA

Are you Parent/Guardian or Chaboya Faculty? *

Parent/Guardian Chaboya Faculty/Sponsor Donation Student

#1 Donor/Member: Interest in Volunteering/Donating (please check all that apply) *

Donating gift cards for Teacher Appreciation Week Volunteering at online events Interest in being a PTSA Board Member Cannot help at this time

#1 Full Name *

First Name Last Name

#1 Email *

Confirmation Email You will be emailed a submission confirmation with all your info submitted.

Add Another Donor/Member? *

Yes No

#2 Donor/Member Name *

First Name Last Name

#2 Donor/Member Email *

Confirmation Email example@example.com

#2 Donor/Member: Interest in Volunteering/Donating (please check all that apply) *

Donating gift cards for Teacher Appreciation Week Volunteering at online events Interest in being a PTSA Board Member Cannot help at this time

Student #1 Name *

First Name Last Name

Student #1 Grade *

7th Grade 8th Grade

Add Another Student? *

Yes No

Student #2 Name *

First Name Last Name

Student #2 Grade

7th Grade 8th Grade

Donation Details

Membership is not limited to parents or guardians, any family member may join PTSA. The fee to become a member is $10.00 per parent.

See PTSA Membership Perks.

My Products

Are you interested in becoming a member of PTSA $ 10.00

Quantity

Option 1: $ 150.00

Quantity

Option 2: $ 250.00

Quantity

Option 3: $ 50.00

Quantity

Other: Enter Custom Amount (pls ignore the $1) $ 1.00

Enter Custom Amount

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Payment Type *

Online - this form (Preferred) Online + Employer Matching Contribution (Preferred)

Employer Matching Contribution Instructions:

If you are not sure if your company provides matching, ask us, or check your Company website.

All the below instructions will be emailed to you once this form is submitted.

1. Add this Form ID# last 6 digits 4396271244022658466 on the memo section of your matching contribution, if possible.

Form ID# is found on the Thank-You pop-up after submitting this form and on the email sent to each Donor/Member.

2. Student's full name on the memo section of your matching contribution.

You will need the following info (this info is emailed to you via your submission of this form):

Chaboya Middle SchoolPTSA

TAX ID (EIN#) 20-539-6029

3276 Cortona Drive San Jose, CA 95135
Phone 408-270-6900

#1 Donor/Member : Sponsor or Employer Matching Company Name. Donations can be matched if your employer has a Company Matching Program. Please enter your company name and we will have a PTSA board contact you via email. *

Company Name

#1 Donor/Member: Enter Amount planned to contribute via Employer Matching *

Example:$100 enter 100

#2 Donor/Member: Donations can be matched if your employer has a Company Matching Program. Please enter your company name and we will have a PTSA board contact you via email.

Company Name

#2 Donor/Member: Enter Amount planned to contribute via Employer Matching

Example:$100 enter 100

Please select which you plan on purchasing by check or cash *

Silver Level (Gifts include Carnival Wristband, Cinch sak, and Chaboya T-Shirt) $150 Gold Level (Silver gifts PLUS Chaboya Hydro flask & Yearbook) $250.00 Platinum Level (Gold gifts PLUS Grade Level Essentials and Personalized Brick) Grade Level Essentials Includes: 7th grade - complete set of gym clothes and bag; 8th grade - promotion gown & panoramic photo $400 Other Options 1 $500 Other Options 2 $100 Other Options 3 $50 Other Options 4 $25 PTSA Member $10

*Please select which you plan on purchasing by check or cash *

Option #1: $150 Option #2: $250 Option #3: $500 Option #4: $100 Option #5: $50 Option #6: $25 PTSA Member $10

Bank Check Donation/Fee(s) Instructions:

All the below instructions will be emailed to you once this form is submitted.

1. Please have the check made out to "Chaboya PTSA"

2. Add this Form ID# 4396271244022658466 last 6 digits on the memo section of your bank check.

Form ID# is found on the Thank-You pop-up after submitting this form and on the email sent to each Donor/Member.

3. Student's full name on the memo section of your bank check.

4. Submit your Check to the Chaboya school office in a sealed envelope with the following on the envelope:

TO: Chaboya PTSA
FROM: Your Name
FORM ID#: This Form's ID#4396271244022658466 (last 6 digits)
STUDENT(S) FULL NAME:

Check # *

Enter Check Amount

For Ex:$100 enter 100

Enter Amount Donated/Fee via Cash

For Ex: $100 enter 100

Donor/Member #1 Information

Student Information

Donation Details

Employer Matching Contribution Instructions:

Bank Check Donation/Fee(s) Instructions: