Single membership is $5.00; please increase fee accordingly for each member application. Please make checks payable to East Middle School PTA. Thank you for your support!

NAME: ___________________________________________________________________________________
(CIRCLE THOSE THAT APPLY) ---- PARENT(S) ---- TEACHER ---- GUARDIAN ---- OTHER

MAILING ADDRESS: ___________________________________ TELEPHONE: _______________________

-------------------------___________________________________ EMAIL: ___________________________

STUDENT NAME: __________________________________ HOMEROOM/TEAM: ____________________

STUDENT NAME: __________________________________ HOMEROOM/TEAM: ____________________

Would you like to be on our email alert list and receive special notices about meetings reminders, upcoming events and news items pertinent to East Middle School?

Circle one: YES or NO