PTA Membership Sign Up Form – Tom Matsumoto PTA

Student Information

Please list all children in the family attending Tom Matsumoto, and submit only one form per family. If you not a parent of the current Matsumoto student(s), please select 0.

Select Number of Students

Student #1 Information

Student Name *

First

Last

Teacher's Name and Grade Level *

Student #2 Information

Student Name *

First

Last

Teacher's Name and Grade Level *

Student #3 Information

Student Name *

First

Last

Teacher's Name and Grade Level *

Member Information

The membership dues are $25/adult

Enter Number of People Signing Up For PTA Membership Today *

*Up to 3 people.

Type of Member *

Enter your relationship to the student(s) – Parent, staff, community member, guardian, grandparents, business, etc

Member #1 Information

Member Name *

First

Last

**If membership type is business, please enter the business name on first name, and NA on last name.

Email *

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Please select all activities you would like to volunteer on

Book Fair
Budget Committee
Bylaws Review Committee
Cultural Club
Enrichment Programs
Family Nights
Fun Committee
Membership Committee
Nomination Committee
Reflections
Spirit Wear
Volunteer Support
Yearbook Committee

Member #2 Information

Member Name *

First

Last

Email *

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Please select all activities you would like to volunteer on

Book Fair
Budget Committee
Bylaws Review Committee
Cultural Club
Enrichment Programs
Family Nights
Fun Committee
Membership Committee
Nomination Committee
Reflections
Spirit Wear
Volunteer Support
Yearbook Committee

Member #3 Information

Member Name *

First

Last

Email *

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Please select all activities you would like to volunteer on

Book Fair
Budget Committee
Bylaws Review Committee
Cultural Club
Enrichment Programs
Family Nights
Fun Committee
Membership Committee
Nomination Committee
Reflections
Spirit Wear
Volunteer Support
Yearbook Committee
None at this time

Donation

A suggested donation of $100 per student is greatly appreciated, but any amount is welcomed! 100% of your donation goes directly to Tom Matsumoto programs and events, and is 100% tax-deductible.

Corporate Matching Grant – Will you be submitting a matching donation request? *

If your company matches employee donations, please provide them with our Federal Tax ID #77-0499036.

Membership Contribution *

Please enter $25.00 X # of adults signing up for membership

Would you like to make donation? *

Enter donation amount (excluding the membership due) *

Would you like to sponsor a teacher/a staff? *