Page 3 - KMS Staff Welcome Back Packet

2020-2021

Membership Form

Questions? Email Abby Polasko at
membership@kenmoreptsa.org
WWW.KENMOREPTSA.ORG

Member Email

Member Email

Member Email

Primary Phone Recieve Text Updates YES NO

Student Name(s) Grade(s)

Check this box if you agree to your student(s) photo/video release for use in KMS PTSA
social media channels, newsletters and the KMS PTSA Website

Help us ensure all students have a GREAT middle school experience!

Membership is a collective voice that directly supports the needs of parents, students and
staff at Kenmore Middle School. There is absolutely NO OBLIGATION to volunteer when you
become a member. Joining the KMS PTSA supports all the programs we provide to our
school and community partners.

Membership and Donations Amount

Membership: 1 Adult - $15 Student - $10
2 Adults - $25 Staff - $10 Scholarship - $0
$
Pass the Hat Donation:
Pass the Hat is PTSA's primary source of funding. We ask that families make a small
donation to fund our many programs that support KMS teachers and students. The
suggested donation is $50 per family, but a donation in any amount is appreciated.
$
Families in Need:
Funds will be directed to programs and services in our school and community that will

directly impact the families and students in Kenmore Middle School.
$

Kenmore Middle School PTSA is a non-profit and all donations are tax deductable.

Grand Total $
Write a single check payable to KMS PTSA

Mail this form and your payment to:
PO Box 82092, Kenmore, WA 98028