Salem Middle School Parent Teacher Association Membership Drive Parent Form

Salem Middle School PTA is committed to making our school a strong educational environment for all of our students. One of the ways you can help is by becoming a member of the PTA. Your participation will help provide for the educational needs of every student in our school, as well as support our school community, staff, administration, and students. The yearly membership fee is $6.00 per individual (one adult voting member) or $9.00 per family (two adult voting members). Please attach your cash or check (made payable to SMS PTA) to the bottom of this form and return it the PTA box, or mail it to the Salem Middle School PTA, c/o Salem Middle School, 6150 Old Jenks Road, Apex, NC 27523. As a member of the PTA at Salem Middle School, you will receive one copy of the Salem Middle School directory. Membership cards will be attached to your directory towards the end of the first quarter. Thank you for your support and for all you do for our children!!! Salem Middle School PTA Membership Chairman Kris Miuccio kmiuccio@aol.com Please return form below and payment with student.

SMS PTA MEMBERSHIP FORM

Parent 1 Name (single): ______________________________________________________ Email Address: ___________________________________________________________________ Parent 2 Name (family): ______________________________________________________ Note: Two names required for family membership Email Address: ___________________________________________________________________ Student Name: _________________________________ Grade: ______ Track: _____ Note: Include the students information who should receive the directory and membership card(s) to bring home when they are printed Homeroom Teacher: ________________________________ For PTA use only Amount Enclosed $ _____________ (Single Membership $6.00 or Family Membership $9.00)
cash date paid card(s) issued

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