CARROLLTON
EARLY CHILDHOOD PTA MEMBER INFORMATION SHEET 2002-2003
Date ____________________
Name ______________________________
Your Birthdate _____________ Spouse’s
Name _________________________________________________________
Address _________________________________________________________ City /
Zip _________________________________________________________
Phone ______________________
E-Mail Address _____________________
Children's Names and Birthdates ___________________________ ________________________ ___________________________ ________________________
___________________________ ________________________
___________________________ ________________________
Sign
below to be included in our Membership Directory (If you would
like to be included but
do not
want your address, phone number or E-mail address to be printed,
please specify)
_______________________________
No address
No Phone #
No E-mail
Check here if you do not wish to receive CEC PTA
announcements via E-mail
How did
you hear about the CEC PTA? ______________________________________
Please
indicate your membership status for this year:
New Member
Alumni Renewing Member
Texas Life Member Grandparent
What
committees and/or activities would you be interested in this year?
(Put a
"P" for participate in, an "H" for help out with,
or a "B" for both)
___
All Around Dallas ___ Membership Coffees ___ Publicity ___ Book Club
___
Family Night ___ Members Night Out ___ Scrapbooking Club ___ Bunco
___
Parent Educ/Library ___ Silent Auction ___ Community Service ___
Fundraising
___
Parties ___ Sunshine Committee ___ Craft Club ___ Hospitality
___
Playgroups ___ Telephone Committee
Are you
interested in hosting a Membership Coffee?
Yes No Month preference ___________
Please
return this form along with a check for $25.00 made payable to
CECPTA to: