Admin

PTA membership form

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.


Membership Level

Membership Incentives

Cost

Amount


Single

1 PTA Membership

$10 per

Individual

$


Bronze

2 PTA Memberships, choice of 1 of the following:

lanyard, water bottle, backpack, or discount card

$25.00-

$49.99 per

Family

$


Silver

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

$50.00-

$99.99 per

Family

$


Gold

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

$100.00 +

$


Please clearly print the following information for each member joining the Sand Lake Elementary PTA.


First & Last Name

E-Mail Address

Member # 1



Member # 2



Member # 3



Member # 4




Gold members only below


Member # 5



Member # 6




FOR PTA USE ONLY

Student's Name

Grade

Teacher

Amount Rec.

$




Received by





Incentives Rec.

Yes or No




Member Cards issued

Yes or No