Mattituck Cutchogue Secondary PTSA
Mattituck
Jr / Sr High School
Together we make a difference!
Mattituck- Cutchogue Secondary PTSA
MEMBERSHIP APPLICATION 2008-2009
___ Family Membership $15.00 (any number in the family)
___ Parent/Guardian/Educator/Staff (each) $5.00
___ Student (7-12)* $3.00 (each)
Member Information:
1. Names of parent/guardian/educator/staff: Last, First
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2. Names of students: Last, First, Grade
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3. Mailing Address: Number, Street, PO Box #, Town
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4. Home phone and/or cell phone
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5. Please list your Email address for notices of meetings, programs, special events, etc.
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6. Are you interested in joining a committee? Check below and we will contact you.
Fashion Show ____ Yankee Candle Fundraiser ____ Bunny Breakfast
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Pre-Prom ____ Membership____Scholarships____ Website____ STAR Program ____
7. Check here if you would like to help on an occasional basis____________
Please make checks payable to:
Mattituck- Cutchogue PTSA
PO Box 250, Mattituck, NY 11952
THANK YOU FOR SUPPORTING THE MATTITUCK-CUTCHOGUE SECONDARY PARENT TEACHER STUDENT ASSOCIATION