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Bellaire High School PTO Membership Form

Last 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

First Name *

Full Name as you would like it to appear for recognition: *

Address *

Phone Number *

Email *

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

Class of 2017 Class of 2018 Class of 2019 Class of 2020

Are you a BHS Staff member? *

Yes No

Does your company offer a matching gift? *

Yes No

Donation Recognition *

Please make my donation anonymous.

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.....................Bellaire HS Faculty/Staff Dues $10........................PTO Membership only $25 - $49...............Crystal Contributor - 1 BHS decal + PTO membership $50 - $99...............Bronze Contributor - BHS decal + PTO membership $100 - $249...........Silver Contributor - BHS decal + PTO membership $250 - $499...........Gold Contributor - BHS yard sign, 2 BHS decals, BHS yard sign + PTO membership $500 - $999...........Platinum Contributor - Invitation to the Prinicpal Reception, BHS yard sign, 2 BHS decals + PTO membership $1,000 + ...................Diamond Contributor - Invitation to the Principal Reception, BHS yard sign, 2 BHS decals + PTO membership ..................................I would like to make an additional donation.

Submit

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