Palmer Middle School PTSA
Membership Form
Please complete the information below for each membership you are purchasing.
Adult Member Name: ___________________________________________
Adult Member Name: ___________________________________________
Student Member Name: _________________________________________
Grade: __________ Homeroom Teacher: ___________________
Student Member Name: _________________________________________
Grade: __________ Homeroom Teacher: ___________________
Address: _________________________City_____________Zip_________
Phone: ________________________E-mail: ________________________
Total Number of Memberships _____ @ $5.00 each =_______
Payment Method: Cash or Check #________
Thank you for supporting the Palmer PTSA!
Membership cards will be sent home with your student.
Palmer Middle School PTSA
Membership Form
Please complete the information below for each membership you are purchasing.
Adult Member Name: ___________________________________________
Adult Member Name: ___________________________________________
Student Member Name: _________________________________________
Grade: __________ Homeroom Teacher: ___________________
Student Member Name: _________________________________________
Grade: __________ Homeroom Teacher: ___________________
Address: _________________________City_____________Zip_________
Phone: ________________________E-mail: ________________________
Total Number of Memberships _____ @ $5.00 each =_______
Payment Method: Cash or Check #________
Thank you for supporting the Palmer PTSA!
Membership cards will be sent home with your student.