Alan Shawn Feinstein Middle School of Coventry

PTSA Membership 2008-2009

$5.00 each adult/$3.00 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