Alan Shawn Feinstein Middle School of Coventry

                PTSA Membership 2009-2010

 

    $6.00 each adult/$4.00 each student

 

Please fill out the following information:

 

Name: _____________________________________________

 

Address: ___________________________________________

               

                ___________________________________________

 

Telephone: ________________   Alt. Phone ______________

 

Email Address: _____________________________________

 

Child’s Name: ______________________________________

 

Child’s Grade: ____________

 

Child’s Team Name: _____________________

 

Child’s Homeroom Number: ___________

 

Child’s Homeroom Teacher: __________________________

 

 

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PAID   Yes/No

 

AMOUNT _____________________

 

CASH OR CHECK