Professional Documents
Culture Documents
First
Middle
Street
City
Zip
Mailing Address:
Parent/Guardian Name(s):
Email Address:
Preferred Phone:
Name of School:
Guidance Counselor:
Are you a PTA/PTSA member?
If yes, PTA/PTSA unit name:
Yes
Alternate Phone:
Graduation Date:
Telephone:
No
Membership Card #:
Please list actual services you have performed along with the organization name. No abbreviations please.
10
11
12
Total
Hours
The overall purpose of PTA is to make every childs potential a reality by engaging and empowering families and
communities to advocate for all children.
Recognition or Award
Paid Employment
Student Name:
10
11
12
Group or Activity
No abbreviations please.
10
11
12
Hours/week
Position
Position
The overall purpose of PTA is to make every childs potential a reality by engaging and empowering families and
communities to advocate for all children.