ROCKY HILL MIDDLE SCHOOL
PTA Membership 2015-16
Parent/Guardian
Name: ___________________________________________________________________________
Name: ___________________________________________________________________________
Email Address*:
____________________________________________________________
Email Address*:
____________________________________________________________
Stay connected with the PTA and sign up to receive updates, events and all things PTA! To subscribe
go to:
http://eepurl.com/brnEVD
or check the box
and we’ll add your email for you!
Student(s)
Name: ____________________________ Grade: _____ Homeroom Teacher: _________________
Name: ____________________________ Grade: _____ Homeroom Teacher: _________________
Staff
Name: ___________________________________________ Position:
_______________________
Annual Membership Dues:
Parent __________ @ $20 each =
________
Staff __________ @ $10 each =
________
Extra Directories__________ @ $ 5 each =
________
I would like to make an additional contribution to the PTA $ ________
Total $ ________
By joining the RHMS PTA you receive membership in the RHMS PTA, the Maryland PTA, and the National PTA. You will also
receive a single copy of the RHMS Directory with your membership. If you wish to purchase additional copies of the RHMS
Directory for $5.00 each, please indicate the number of additional copies and include that with your membership dues
above. The directory will be distributed in the fall.
Please make checks payable to: RHMS PTA
Forms may be placed in an envelope along with payment and dropped off at the front office.
You may also mail your membership form along with payment to:
Rocky Hill Middle School, PTA Membership, 22401 Brick Haven Way, Clarksburg, MD 20871
The PTA hereby acknowledges that the information contained herein will NOT be shared with anyone and will be used for the
sole purpose of what it is intended as stated above.
Directory withholding information will be based on your completed MCPS form
titled "Your Rights Regarding Student Records and Directory Information".
Thank you for joining YOUR Rocky Hill Middle School PTA!
If you have any questions, please contact Diana Encinas [email protected]
PTA Membership Chair.