TMS DIRECT APPEAL CONTRIBUTION
PTSA MEMBERSHIP FORM
(Please print!)
Student Name________________________________________________
Grade__________
Student Name________________________________________________
Grade__________
Student Name________________________________________________
Grade__________
Parent/Guardian Name (#1) ___________________________________________________________________
Parent/Guardian Name (#2)____________________________________________________________________
Phone# 1 _______________________________ (H/W/C) Phone #2 __________________________ (H/W/C)
Street Address______________________________________________________________________________
City, State, Zip _____________________________________________________________________________
First Member E-mail
Second Member E-mail
**VERY IMPORTANT**
We would like to recognize your support by thanking you in one or more of the following ways: Newsletter, PTSA
Bulletin Board, TMS Website, etc. Please indicate only if you WOULD NOT like to be recognized.
_____ No, I would prefer not to be recognized as a contributor to the Direct Appeal Campaign.
ITEM
Direct Appeal Campaign Contribution
Tilden Supporters - up to $99 Timberwolves - $250 - $499
Friends of Tilden - $100 - $249 Wolf Pack - $500 or more
PTSA Membership ($25.00)
Member Name #1 _____________________________________
PTSA Membership – 2nd membership ($10.00)
Member Name #2______________________________________
EXTRA DIRECTORY ($5 EACH)
$ AMOUNT ENCLOSED
Direct
Appeal
$ _______________
PTSA #1
$ _______________
PTSA #2
$ _______________
$ __________________
$ _______________
$ ________________
TOTAL AMOUNT OF CASH OR CHECK (MAKE CHECKS PAYABLE TO TMS PTSA)