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Bellaire High School PTO

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Bellaire High School PTO Membership Form

Contributor's Name *

Please list name the way you would like it to appear with recognition of your membership. For example, Bob and Sue Smith or The Smith Family

Address *

Phone Number *

Email *

What Class(es) do you have students in? *

Class of 2012 Class of 2013 Class of 2014 Class of 2015

Is your student a magent student? *

Yes No

Are you a BHS Staff member? *

Yes No

What level would you like to support the PTO at? After you submit your information you will be able to make your payment with a credit card or paypal account. *

$5.00.....................Teacher Membership $10........................PTO Membership Dues - Per Family $25 - $49...............Crystal Contributor (PTO Membership Included) $50 - $99...............Bronze Contributor (PTO Membership Included) $100 - $249...........Silver Contributor (PTO Membership Included) $250 - $499...........Gold Contributor (PTO Membership Included) $500 - $999...........Platinum Contributor (PTO Membership Included) $1,000 + ...................Diamond Contributor (PTO Membership Included) ..................................I would like to make an additional donation.

Does your company offer a matching gift? *

Yes No

Donation Recognition *

Please make my donation anonymous.

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