O'MALLEY ELEMENTARY
PTA MEMBERSHIP FORM
2007-2008
PTA MEMBERSHIP FEE: (INCLUDES COPY OF DIRECTORY)
TOTALS
ONE ADULT: $7.00 ________
FAMILY: (Two Adults) $14.00 ________
COMFORT KIT $10.00  * __________ ________
ADDITIONAL DONATION   _________
 

TOTAL

  

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__________________________________________________    ________________________________________________________________
#1 ADULT LAST NAME    #1 ADULT FIRST NAME
__________________________________________________    ________________________________________________________________
#2 ADULT LAST NAME    #2 ADULT FIRST NAME

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ADDRESS:   __________________________________________________________________________________________________

PHONE NUMBER: (H)_____________________________________

EMAIL ADDRESS: ______________________________________________________________________________________________________
   NEEDED FOR ANNOUNCEMENTS & NEWSLETTER)

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STUDENT'S NAME(S):     GRADE     TEACHER
1)  _________________________________________    _____________    _____________

2)  _________________________________________    _____________    _____________

3)  _________________________________________    _____________    _____________

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* * *  Please make checks payable to O'MALLEY PTA - Donations are tax deductible * * *
 
AMOUNT ENCLOSED: _________________________ CHECK  _________________________ CASH____________ 

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