Membership Form — Fox Mill Pta

Annual Membership Dues include National, State and Local

Filling out this form will automatically sign you up for Fox Prints

Member Information

Member Name 1

First Name

Last Name

Member 1

Member Name 2

First Name

Last Name

Member 2

Address

Phone

(###)

###

####

Email Address

Student Information

Students Name

First Name

Last Name

Teacher

Students Name

First Name

Last Name

Teacher

Student Name

First Name

Last Name

Teacher

Directory Printing Options

Choose one

No, Please do not include my student in the school directory at all.

Yes, I want my student listed in the school directory.

Yes, I want my student listed in the school directory BUT exclude the following information:

Exclude from directory, if applicable:

Address

Phone Number

Email Address