Student's Name
*
First Name
Last Name
Primary Parent's Name
*
First Name
Last Name
Secondary Parent's Name
First Name
Last Name
Primary Parent's E-mail
*
example@example.com
Secondary Parent E-mail
example@example.com
Primary Parent's Cell
-
Area Code
Phone Number
Secondary Parent's Cell
-
Area Code
Phone Number
I am interested in serving on the Rosa PTO Board on the following committees:
Fundraising (fall)
Homecoming Dance (fall)
Proctoring (spring)
Staff Appreciation
As Needed
Grounds
Veteran's Day (November)
My Products
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Basic PTO Membership
$
40.00
Includes early schedule pick-up & one class T-shirt that students will wear on the first day of school (please indicate size below)
Jag Level Membership
$
140.00
In addition to the basic membership & class shirt, this also includes full participation in Rosa Scott PTO's primary fundraiser with 20 entries to the raffle and student incentives.
Class T-shirt (included in PTO membership)
$
Free
Size
S
M
L
XL
XXL
Additional T-shirt
$
10.00
Size
S
M
L
XL
XXL
Additional T-shirt
$
10.00
Size
S
M
L
XL
XXL
Donation for Teacher / Staff Appreciation
$
10.00
Quantity
1
2
3
4
5
6
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9
10
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12
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15
16
17
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40
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43
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45
46
47
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49
50
Total
$
0.00
Credit Card
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