Sand Lake Elementary PTA
Ride the Waves to Success
PTA MEMBERSHIP FORM
Level of Membership Desired:
Please indicate your desired membership by placing a checkmark next to the level & entering the amount. Turn this form in with the correct payment to the front office or your child’s teacher. Please make checks payable to SAND LAKE ELEMENTARY PTA.
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Membership Level
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Membership Incentives
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Cost
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Amount
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Single
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1 PTA Membership
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$10 per
Individual
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$
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Bronze
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2 PTA Memberships, choice of 1 of the following:
lanyard, water bottle, backpack, or discount card
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$25.00-
$49.99 per
Family
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$
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Silver
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4 PTA Memberships, choice of 1 of the following:
lanyard, water bottle, or backpack.
Also included, $5 Spirit Wear coupon, discount card and coffee with Principal Suprenard
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$50.00-
$99.99 per
Family
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$
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Gold
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6 PTA Memberships, choice of 1 of the following:
lanyard, water bottle or backpack.
Also included, 1 Yearbook, $5 Spirit Wear coupon, discount card, coffee with Principal Suprenard, recognition in the school newsletter and 1 entry into a drawing for 1 of 2 front row school parking lot spaces with family name on signage
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$100.00 +
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$
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Please clearly print the following information for each member joining the Sand Lake Elementary PTA.
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First & Last Name
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E-Mail Address
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Member # 1
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Member # 2
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Member # 3
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Member # 4
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Gold members only below
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Member # 5
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Member # 6
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FOR PTA USE ONLY
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Student’s Name
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Grade
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Teacher
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Amount Rec.
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$
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Received by
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Incentives Rec.
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Yes or No
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Member Cards issued
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Yes or No
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