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Drake PTSA Membership

Please use this form to Join the Drake Middle School PTSA and to make any additional donations to the Drake PTSA
First Name:
Last Name:
Title (optional):
Organization (optional):
Address:
City:
State:
(ignore for non-US transactions)
Zip Code:
Country:
Email Address:
Confirm Email Address:
Preferred Phone:
Credit Card Billing Address
 
 If the address where you receive the credit card bill is different than above, please enter it here.
Address:
City:
State:
Zip Code:
 

Student name(s), Grade(s)
What Drake Team is your student on? Steamboat Vail Breckenridge Aspen Sunlight
Member First Name
Member Last Name
Relationship to Student Parent Grandparent other
Cell Phone Number
Email address
Home Address
Home Phone
For Family Memberships please list the additional family members
I'm happy to help with Food Donations throughout the year Yes
I'm happy to help with the Dragon Dash Yes
I'm happy to help with other PTSA Activities Yes
Check No
Select your level of Membership
Individual Membership ($15.00) - This membership is for just 1 person in the family.
Family Membership ($25.00) - This membership level is for 2 or more members from the same family
Charge Amount:
  Other Amount --> $
  You can choose any amount you'd like by checking the box for the amount you'd like to give, or by checking the Other option and entering a custom amount in the blank field.
Pay by Credit Card  
Card Type:
Credit Card Number:
Credit Card Expiration (mm/yy): /
Name On Card:
C V V Value:
 
We appreciate your support!