Membership 2009-2010

NAME: _______________________________________________________________

Child(ren) at BMS ______________________________ Grade(s)_________________________

MEMBERSHIP LEVEL (Check one):

$8.00 ______ (includes paw print keychain to the first 100 members)

$10.00 _____ (includes Bellport Pride Backpack to the first 100 members)

EMAIL ADDRESS: ________________________________________________________________

PHONE: ________________________________________________________________

Available to volunteer: Yes _____ No _______ (Email or phone contact will be made on occasion to request assistance, this is not obligatory.)

Please check the topics you would be interested in learning more about at future PTA meetings

Internet Safety _____________ Bullying ________________ Parenting Skills _________

Testing Explained ___________ Gang Awareness _________ Curriculum ____________

Drug/Alcohol Awareness ______

Other Health Issues _______

Other ideas not previously mentioned. Your thoughts and comments are appreciated. _________________________________________________ _________________________________________________

THANK YOU FOR BEING PART OF THE PTA - EVERY CHILD. ONE VOICE.

Please mail form with payment to: Bellport Middle School PTA Membership, 35 Kreamer Street, Bellport, NY, 11713

We will notify you by email when your membership card and gift will be available for pickup at the school.

Thank you for your interest in the Bellport Middle School PTA.