PTA MEMBER FORM

Thank you for your interest in joining the Leonardtown Elementary School PTA! Please fill out the form below and return it to LES along with your dues payment. When PTA gets involved, children benefit. When you get involved with PTA, the child who benefits the most is your own.   

Parent/Guardian:______________________________________________($6)

Second Adult:________________________________________________($4)

Address:_____________________________________________________

____________________________________________________________

Telephone:__________________ *E-Mail:__________________________

Preferred Method for Contact (circle one)  Phone - Email

Student:________________________ Grade/Teacher________________________-

Student:________________________ Grade/Teacher:_________________________

Student:_________________________Grade/Teacher:_________________________

Amt. Pd.___________ cash  check  ck#______ Date_______ Initials______